OUTCOMES AFTER TRAUMATIC INJURY

According to the World Health Organization (WHO), nearly 45 million people worldwide acquire a disability due to trauma. Patients who survive severe injury are often left permanently disabled and dependent on family and the state for support. Most research in trauma care focus on the use of mortality as an outcome. While death is easier to measure, it does not measure or capture interventions that may improve the patient experience, reduce complications and long-term disability.

Our research into outcomes after traumatic injury focuses on:

  • Measuring intermediate and long-term outcomes in trauma patients including quality of life, employment, post-traumatic stress, return to previous activities
  • Developing patient-focused outcome measures for trauma clinical trials
  • Understanding which aspects of acute care impact on intermediate & long-term outcomes
  • Developing a Trauma core set to measure rehabilitation needs and outcome of patients using the International Classification of Function, disability and health (WHO ICF)
  • Evaluating rehabilitation requirements in relation to injury severity to improve recovery and rehabilitation of trauma patients
  • Developing resources to inform and support families and promote recovery of patients
  • Evaluating and measuring quality in the design and evaluation of regional trauma systems

Our current research projects are described below. Past studies can be found here

ICF Trauma Rehabilitation Core Set

Globally, little is known about the effectiveness of different rehabilitation interventions for people recovering from major traumatic injury. One of the reasons for this is the lack of an agreed framework for measuring rehabilitation needs and outcomes. For this reason, C4TS has undertaken research to develop the world's first ICF Core Set for trauma rehabilitation. More information here

Digital Self-management tools for Recovering Trauma Survivors

In the UK, civilian survivors of traumatic injury are provided with little rehabilitation and emotional support once they are discharged from hospital, and often describe their experience as "like falling off a cliff".  In a UK first, C4TS established the patient-facing AfterTrauma website in April 2015 to provide trauma survivors and carers with a single portal for finding plain English information about injuries, psychological impacts, where to get help, and a community forum where survivors and their families could connect.  

In May 2016, C4TS received a 3 year project grant from Barts Charity to extend the functionality of AfterTrauma into a supported self management application to help survivors of traumatic injury better manage their recovery. Self-management programs aim to provide people with health conditions with the tools, knowledge and motivation to help them better manage their health and enjoy an improved quality of life.  There are currently no digital self-management platforms in the UK designed specifically for survivors of traumatic injury. Click here to find out more about this project.

Staff and Publications

Research Lead:

Professor Karim Brohi

QM Co-investigators:

Anita West

Research Team:

Dr Karen Hoffman

Dr Elaine Cole

Dr Ross Davenport 

Collaborators:

Prof. Eva Grill and Dr. Martin Muller

Dr. Helene Soberg

 

 

Findings

  • We have developed a pioneering trauma core set of function, disability and health measures designed to help clinicians evaluate the health and rehabilitation outcomes of severely injured patients.

Findings

  • Admission shock, prolonged lymphopenia and early coagulation dysfunction post severe injury are independent predictors of infection
  • Administration of TXA is associated with reduced rates of infection and organ failure

Findings

  • More patients are receiving good care following the implementation of the London Trauma System in 2010
  • The inclusive London Trauma System has resulted in improved access to specialist care and timely early management. These process improvements are associated with overall mortality benefits for severely injured patients

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