REHABILITATION RESULTS OF PATIENTS WITH MULTIPLE INJURIES AND MULTIPLE ORGAN FAILURE AND LONG-TERM INTENSIVE-CARE

Background: Multiple organ failure is regarded to be the major complic ation of trauma victims treated in the intensive care unit. Long-term rehabilitation results of this special group of patients have not been analyzed so far, Methods: Fifty patients with multiple injuries and m ultiple organ failure (Injury Severity Score greater than or equal to 36.8) were followed-up 4.9 +/- 0.3 years after the trauma. To show any organotopic sequelae, laboratory tests for the function of lungs, liv er, kidney, and the hematologic system were performed, Additionally th eir functional (locomotion and neurologic system) and occupational reh abilitation results were investigated, Results: The laboratory tests s howed entirely normal results, The only pathologic values could be fou nd in the lung function tests, Nineteen percent of the patients showed nonphysiologic results in either spirometry, body plethysmography, or diffusion capacity of carbon monoxide. In more than 25% of the patien ts, permanently decreased range of motion (limitation of more than 30% of the entire range of motion) of the elbow, hip, knee, or ankle join t were found, In 40% of the patients, permanent motoric nerve lesions were identified; in 50% of the patients, permanent sensoric nerve lesi ons could be verified, The return to work rate was 60%, Conclusions: P atients with multiple injuries, who survived multiple organ failure du ring their long-term intensive care treatment, show an excellent funct ional and occupational rehabilitation result, They show no major seque lae in their organ function even years after the trauma, Although ofte n these patients suffer from permanent central or peripheral paralysis and decreased range of motion, this finding does not correlate with t he patients' ability to return to work.