TY  - JOUR
PY  - 2019//
TI  - Resilience and long-term outcomes after trauma: an opportunity for early intervention?
JO  - Journal of trauma and acute care surgery
A1  - Nehra, Deepika
A1  - Herrera-Escobar, Juan P.
A1  - Al Rafai, Syeda S.
A1  - Havens, Joaquim
A1  - Askari, Reza
A1  - Nitzschke, Stephanie
A1  - Velmahos, George
A1  - Kasotakis, George
A1  - Brasel, Karen J.
A1  - Levy-Carrick, Nomi
A1  - Salim, Ali
A1  - Haider, Adil
SP  - 782
EP  - 789
VL  - 87
IS  - 4
N2  - BACKGROUND: Resilience, or the ability to cope with difficulties, influences an individual's response to life events including unexpected injury. We sought to assess the relationship between patient self-reported resilience traits and functional and psychosocial outcomes 6 months after traumatic injury. <br><br>METHODS: Adult trauma patients 18 years to 64 years of age with moderate to severe injuries (Injury Severity Score, ≥9) admitted to one of three Level I trauma centers between 2015 and 2017 were contacted by phone at 6 months postinjury and asked to complete a validated Trauma Quality of Life (T-QoL) survey and PTSD screen. Patients were classified into "low" and "high" resilience categories. Long-term outcomes were compared between groups. Adjusted logistic regression models were built to determine the association between resilience and each of the long-term outcomes. <br><br>RESULTS: A total of 305 patients completed the 6-month interview. Two hundred four (67%) of the 305 patients were classified as having low resilience. Mean age was 42 ± 14 years, 65% were male, 91% suffering a blunt injury, and average Injury Severity Score was 15.4 ± 7.9. Patients in the low-resilience group had significantly higher odds of functional limitations in activities of daily living (odds ratio [OR], 4.81; 95% confidence interval [CI], 2.48-9.34). In addition, patients in the lower resilience group were less likely to have returned to work/school (OR, 3.25; 95% CI, 1.71-6.19), more likely to report chronic pain (OR, 2.57; 95% CI, 1.54-4.30) and more likely to screen positive for PTSD (OR, 2.96; 95% CI, 1.58-5.54). <br><br>CONCLUSION: Patients with low resilience demonstrated worse functional and psychosocial outcomes 6 months after injury. These data suggest that screening for resilience and developing and deploying early interventions to improve resilience-associated traits as soon as possible after injury may hold promise for improving important long-term functional outcomes. LEVEL OF EVIDENCE: Prognostic, level II.<p />  <p>Language: en</p>
LA  - en
SN  - 2163-0755
UR  - http://dx.doi.org/10.1097/TA.0000000000002442
ID  - ref1
ER  -