Outcome after musculoskeletal trauma treated in a regional hospital

Background: Trauma remains the leading cause of death and morbidity in the under-35-year-old population. The majority of reports assessing outcome aft er trauma emanate from North American Level I trauma centers. We sought to examine outcome after trauma treated in an Irish regional unit, Methods: An patients admitted over a 1-year period with an Injury Severity Score greater than or equal to 9 were evaluated and 61 patients recruited t o the study. Demographic data, medical history, and details of the mechanis m and pattern of injury and treatment were collected. Patients' functional outcome was assessed using the Sickness Impact Profile (SIP), duration of h ospital stay, and return to work. Results: Significant residual disability was noted (mean SIP 13.63 +/- 14.6 0). Thirty-seven percent of patients had not returned to work despite a mea n follow-up of 18.36 months. Factors associated with a poor outcome include increasing age, a blue-collar occupation, lower limb fractures, comorbid c onditions, and the presence of complications. Conclusion: Optimizing primary care of the trauma victim may help to minimi ze consequent morbidity, A small group of patients suffer permanent disabil ity, and vocational retraining opportunities should be made available to th em.