Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis

David, Siddarth; Aroke, Anna; Roy, Nobhojit; Solomon, Harris; Lundborg, Cecilia Stålsby; Wärnberg, Martin Gerdin

doi:10.1016/j.injury.2021.10.012

Cited by 8 publications

(7 citation statements)

References 103 publications

(112 reference statements)

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“…As being employed positively influences health and well-being, 80 return to work is among the most-studied socioeconomic outcomes in research among trauma patients. 81 A systematic review and meta-analysis comprising 43 studies showed that more than 36% of adult trauma patients had not returned to work during the first year following discharge, 11 reflecting the mental and physical burden among survivors of physical trauma. The average NISS score in our study population was 23 (range 13–29), categorising the participants as severely injured (NISS>15), and most had yet to return to full-time work or study at 18 months postdischarge.…”

Section: Discussionmentioning

confidence: 99%

“…Trauma survivors frequently sustain mental and physical impairments that significantly affect their quality of life,9 10 and research has shown that more than one-third of trauma patients do not return to work 1 year after injury,11 reflecting the severe injury burden. Furthermore, longitudinal cohort studies conducted during the 3 years following injury have shown that trauma patients report a high prevalence of ongoing problems with pain, anxiety, depression, daily activities and reduced mobility and self-care 12 13…”

Section: Introductionmentioning

confidence: 99%

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A qualitative longitudinal study of traumatic orthopaedic injury survivors’ experiences with pain and the long-term recovery trajectory

Finstad,

Røise,

Clausen

et al. 2024

BMJ Open

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ObjectivesTo explore trauma patients’ experiences of the long-term recovery pathway during 18 months following hospital discharge.DesignLongitudinal qualitative study.Setting and participantsThirteen trauma patients with injuries associated with pain that had been interviewed 6 weeks after discharge from Oslo University Hospital in Norway, were followed up with an interview 18 months postdischarge.MethodThe illness trajectory framework informed the data collection, with semistructured, in-depth interviews that were analysed thematically.ResultsCompared with the subacute phase 6 weeks postdischarge, several participants reported exacerbated mental and physical health, including increased pain during 18 months following discharge. This, andalternating periods of deteriorated health status during recovery, made the pathway unpredictable. At 18 months post-discharge, participants were coping with experiences of reduced mental and physical health and socioeconomic losses. Three main themes were identified: (1) coping with persistent pain and reduced physical function, (2) experiencing mental distress without access to mental healthcare and (3) unmet needs for follow-up care. Moreover, at 18 months postdischarge, prescribed opioids were found to be easily accessible from GPs. In addition to relieving chronic pain, motivations to use opioids were to induce sleep, reduce withdrawal symptoms and relieve mental distress.Conclusions and implicationsThe patients’ experiences from this study establish knowledge of several challenges in the trauma population’s recovery trajectories, which may imply that subacute health status is a poor predictor of long-term outcomes. Throughout recovery, the participants struggled with physical and mental health needs without being met by the healthcare system. Therefore, it is necessary to provide long-term follow-up of trauma patients’ health status in the specialist health service based on individual needs. Additionally, to prevent long-term opioid use beyond the subacute phase, there is a need to systematically follow-up and reassess motivations and indications for continued use throughout the recovery pathway.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A qualitative longitudinal study of traumatic orthopaedic injury survivors’ experiences with pain and the long-term recovery trajectory

Finstad,

Røise,

Clausen

et al. 2024

BMJ Open

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“…Injury is a global health concern, and the economic burden attributed to the management of patients with trauma haemorrhage is significant; for example, it was estimated that in England the cost of managing haemorrhage after trauma was GBP 168 million per year [ 8 , 9 ]. Despite extensive efforts to improve clinical management and patient outcomes, trauma remains a clinical and socioeconomic issue of major relevance for young people and is becoming a larger issue for the elderly [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Experimental Models of Traumatic Injuries: Do They Capture the Coagulopathy and Underlying Endotheliopathy Induced by Human Trauma?

Barrett

Curry

Abu-Hanna

2023

IJMS

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Trauma-induced coagulopathy (TIC) is a major cause of morbidity and mortality in patients with traumatic injury. It describes the spectrum of coagulation abnormalities that occur because of the trauma itself and the body’s response to the trauma. These coagulation abnormalities range from hypocoagulability and hyperfibrinolysis, resulting in potentially fatal bleeding, in the early stages of trauma to hypercoagulability, leading to widespread clot formation, in the later stages. Pathological changes in the vascular endothelium and its regulation of haemostasis, a phenomenon known as the endotheliopathy of trauma (EoT), are thought to underlie TIC. Our understanding of EoT and its contribution to TIC remains in its infancy largely due to the scarcity of experimental research. This review discusses the mechanisms employed by the vascular endothelium to regulate haemostasis and their dysregulation following traumatic injury before providing an overview of the available experimental in vitro and in vivo models of trauma and their applicability for the study of the EoT and its contribution to TIC.

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“…One-third of people admitted to hospital following serious injury do not return to work (RTW) within 12 months (David et al, 2022). Those that do, may suffer from physical and mental health problems, including pain, fatigue, anxiety, depression and post-traumatic stress disorder, which threaten work stability (Cancelliere et al, 2016; Kendrick et al, 2017; Vardon-Bounes et al, 2021; Vitturi et al, 2022) and increase health resource use.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of occupational therapy supporting return to work for people who sustain serious injuries or develop long-term (physical or mental) health conditions: A systematic review

Pérez

McQueen

Craven

et al. 2023

British Journal of Occupational Therapy

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Introduction: People with long-term conditions or recovering from serious injuries can struggle to return to work. The evidence for occupational therapy supporting return to work is limited. We aimed to identify and explain how occupational therapy interventions work. Methods: Systematic review. Seven databases were searched between 1 January 1980 and 15 June 2022. Studies measuring work-related outcomes among individuals receiving occupational therapy during absence from paid work were included. Multiple reviewers independently contributed to screening, quality appraisal and data extraction processes. Data were analysed as a narrative. Results: Twenty studies with 3866 participants were included; 17 were assessed as having high risk of bias. Occupational therapy was inconsistently acknowledged affecting study identification and occupational therapy components were poorly described. Meta-analysis was unfeasible due to outcome heterogeneity. Individually tailored occupational therapy focused on return to work in musculoskeletal conditions indicated the most promising outcomes. Key intervention components included vocational assessment, goal setting and self-management. Key mechanisms of action included early intervention, individualised support and being responsive to needs. Conclusion: Occupational therapists’ contributions supporting return to work should be clearly attributed. Future effectiveness research should standardise the measurement of work outcomes to support meta-analysis. Developing a taxonomy for occupational therapy supporting return to work could facilitate comparisons across studies, highlighting occupational therapists’ roles and facilitating training and benefits to patients.

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Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis

Abstract: W ärnberg , Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis, Injury (2021), doi:

Cited by 8 publications

References 103 publications

A qualitative longitudinal study of traumatic orthopaedic injury survivors’ experiences with pain and the long-term recovery trajectory

A qualitative longitudinal study of traumatic orthopaedic injury survivors’ experiences with pain and the long-term recovery trajectory

Experimental Models of Traumatic Injuries: Do They Capture the Coagulopathy and Underlying Endotheliopathy Induced by Human Trauma?

The effectiveness of occupational therapy supporting return to work for people who sustain serious injuries or develop long-term (physical or mental) health conditions: A systematic review

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