Beyond pain and disability: The lasting effects of trauma on life after injury

Abstract

In support of improving patient care, this activity has been planned and implemented by CineMed and the American Association for the Surgery of Trauma. CineMed is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. AMA PRA Category 1 Credits™CineMed designates this enduing material for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ObjectivesAfter reading the featured articles published in the Journal of Trauma and Acute Care Surgery, participants should be able to demonstrate increased understanding of the material specific to the article. Objectives for each article are featured at the beginning of each article and online. Test questions are at the end of the article, with a critique and specific location in the article referencing the question topic.

Effects of prior injury on long term patient reported outcomes after trauma

“…This would be consistent with a body of literature showing that an individual’s global traumatic stress burden over time is a predictor for PTSD development 28,29 . This study is one of many affirming the need for a robust posttrauma support network to address the impacts of injury on medical comorbidity, substance abuse, mental health, physical function, and societal participation 5–9,30 …”

“…A higher proportion of patients with PTI screened positive for PTSD at 6-month follow-up, although this difference was not statistically significant (14 [37.8%] vs. 11 [20.0%], p = 0.059). Pain intensity scores were similar between patients with and without PTI at 6 months (5 [1][2][3][4][5][6][7] vs. 3 [1][2][3][4][5][6][7], p = 0.92). There were no significant differences in the change of T score over 6 months of follow-up in most health domains between patients with and without PTI (Table 5).…”

“…However, the long-term outcomes for the majority of trauma patients that will survive their initial hospitalization remain poorly characterized 3 . Recent evidence shows that patients have substantial long-term challenges across multiple health related domains after injury, including physical function, medical comorbid conditions, mental health, and reintegration into social and economic life 4–8 . As the magnitude of the long-term burden due to trauma has become clearer, there has been a growing call to focus efforts on fully characterizing traumatic injury as a chronic disease and aligning policy to support optimal trauma survivorship 9 …”

“…3 Recent evidence shows that patients have substantial long-term challenges across multiple health related domains after injury, including physical function, medical comorbid conditions, mental health, and reintegration into social and economic life. [4][5][6][7][8] As the magnitude of the long-term burden due to trauma has become clearer, there has been a growing call to focus efforts on fully characterizing traumatic injury as a chronic disease and aligning policy to support optimal trauma survivorship. 9 Trauma surgeons have long recognized the risk of recurrent injury as another component of this chronic disease process, and many studies have shown that a substantial proportion of trauma patients will experience another significant injury.…”

It is not a simple ankle fracture: 2023 Scott B. Frame Memorial Lecture

“…But shouldn't we? A study by Hatchimonji et al 7 was presented at EAST last year showed the lingering effect of trauma, not just on depression, but on other facets of life that patient’s value such as the ability to participate in social activities.…”