QUALITY-OF-LIFE AFTER SEVERE MULTIPLE TRA UMA

Quality of life (QoL) was analyzed in 73 patients with severe multiple trauma (PTS greater than or equal to 40 patients) between 1 and 13 ye ars after injury. QoL was assessed by the Aachen Longtime Outcome Scor e (ALOS), the Spitzer Index (SI) and individual self-assessment. The p atients were asked about further social, financial, psychological and physical items. According to the ALOS, 81% of the patients showed mode rate, 14% severe and 5% no disability. In 66% of the patients a favora ble Spitzerindex (8 - 10 points) was found. Only 14% had poor SI score s (0-4 points). Also. two out of three patients regarded the current s tate of their health as ''good'' or ''very good'' Predominantly, handi caps resulted from permanent physical disability, in particular the lo wer extremities, whereas psychosocial and financial problems were repo rted infrequently. Besides injuries to the head or extremities? low Qo L correlated with severity of injury and increasing age. Within the fi rst 4 post-traumatic years SI and ALOS, as well as individual self-ass essment, improved with time after injury. The rate of patients who ret urned to work (69%) was similar to other multiple trauma series, inclu ding series with less severe injuries. The reasonable long-term outcom e even after severe multiple trauma seems to justify the enormous staf f and economic expense required to manage these patients. Further impr ovement in QoL may be achieved by professional psychological support a nd early fracture treatment.