BACKGROUND: Despite the availability of routinely collected trauma data; rehabilitation outcomes, functional evaluation and comparative effectiveness research have not incorporated this potentially clinically meaningful information in its modeling as predictors or adjustors.
OBJECTIVE: The purpose of this study was to identify variables from the scene of a traumatic accident and from the emergency department (ED) that can be used in assessing functional outcomes of persons who survive trauma.
DESIGN: Prospective study. SETTING: Level I academic trauma center. PATIENTS: Persons who sustained and survived a Spinal Cord Injury (SCI), a Traumatic Brain Injury (TBI), or a Polytrauma (Poly-T).
METHODS: Trauma and rehabilitation registries were merged by matching the two data files on each patient by medical record number and verified by sex and date of birth. Analysis consisted of standard descriptive statistics: frequencies and averages. A two staged linear regression was used to investigate the relationship between the demographic, scene and ED data elements and discharge functional outcome. MAIN OUTCOME MEASUREMENT: Discharge Functional Independence Measure (FIM) RESULTS: Older patients with government insurance had poorer discharge FIM scores compared to those with commercial insurance. Injury Severity Score (ISS) and Glasgow Coma Score (GCS) from scene of the accident were significantly associated with the discharge FIM. Persons with a lower ISS had significantly higher discharge FIM scores than persons with higher ISS (p <.001). For every unit change in GCS score, FIM scores increased by.488 points (p =.030).
CONCLUSION: The use of routinely collected trauma data elements can be useful in assessing the continuum of patient care. Incorporating trauma data has the potential to improve our models of functional outcomes and provide meaningful risk adjustors when comparing and evaluating rehabilitation care systems and treatments.