Unmet Rehabilitation Needs in the First 6 Months Post-injury in a Trauma Centre Population with Moderate-to-severe Traumatic Injuries

Overview

Journal J Rehabil Med

Specialty Rehabilitation Medicine

Date 2024 May 28

PMID 38803207

Authors

Hakon Ogreid Moksnes

Nada Andelic

Christoph Schafer

Audny Anke

Helene Lundgaard Soberg

Cecilie Roe

Emilie Isager Howe

Marit V Forslund

Olav Roise

Hilde Margrete Dahl

Frank Becker

Marianne Lovstad

Paul B Perrin

Juan Lu

Unni Sveen

Torgeir Hellstrom

Mari S Rasmussen

Affiliations

Soon will be listed here.

Abstract

Objective: To describe the needs for subacute inpatient rehabilitation and community-based healthcare services, rehabilitation, and social support in patients with moderate-to-severe traumatic injury in the first 6 months post-injury. Further, to explore associations between sociodemographic and clinical characteristics and unmet needs.

Design: Multicentre prospective cohort study.

Subjects: Of 601 persons (75% males), mean (standard deviation) age 47 (21) years, admitted to trauma centres in 2020 with moderate-to-severe injury, 501 patients responded at the 6-month follow-up and thus were included in the analyses.

Methods: Sociodemographic and injury-related characteristics were recorded at inclusion. Estimation of needs was assessed with the Rehabilitation Complexity Scale Extended-Trauma and the Needs and Provision Complexity Scale on hospital discharge. Provision of services was recorded 6 months post-injury. Multivariable logistic regressions explored associations between baseline variables and unmet inpatient rehabilitation and community-based service needs.

Results: In total, 20% exhibited unmet needs for subacute inpatient rehabilitation, compared with 60% for community-based services. Predictors for unmet community-based service needs included residing in less central areas, profound injury severity, severe head injury, and rehabilitation referral before returning home.

Conclusion: Inadequate provision of healthcare and rehabilitation services, particularly in the municipalities, resulted in substantial unmet needs in the first 6 months following injury.

Citing Articles

Health care costs and service utilization in the first year following moderate to severe traumatic injury.

Rasmussen M, Zhang Y, Andelic N, Aas E BMC Health Serv Res. 2024; 24(1):1535.

PMID: 39627835 PMC: 11616367. DOI: 10.1186/s12913-024-12016-6.

References

Gabbe B, Simpson P, Harrison J, Lyons R, Ameratunga S, Ponsford J . Return to Work and Functional Outcomes After Major Trauma: Who Recovers, When, and How Well?. Ann Surg. 2016; 263(4):623-32. DOI: 10.1097/SLA.0000000000001564. View

Andelic N, Soberg H, Berntsen S, Sigurdardottir S, Roe C . Self-perceived health care needs and delivery of health care services 5 years after moderate-to-severe traumatic brain injury. PM R. 2014; 6(11):1013-21. DOI: 10.1016/j.pmrj.2014.05.005. View

Koo T, Li M . A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016; 15(2):155-63. PMC: 4913118. DOI: 10.1016/j.jcm.2016.02.012. View

van Breugel J, Niemeyer M, Houwert R, Groenwold R, Leenen L, van Wessem K . Global changes in mortality rates in polytrauma patients admitted to the ICU-a systematic review. World J Emerg Surg. 2020; 15(1):55. PMC: 7526208. DOI: 10.1186/s13017-020-00330-3. View

Polinder S, van Beeck E, Essink-Bot M, Toet H, Looman C, Mulder S . Functional outcome at 2.5, 5, 9, and 24 months after injury in the Netherlands. J Trauma. 2007; 62(1):133-41. DOI: 10.1097/TA.0b013e31802b71c9. View

Siegert R, Jackson D, Playford E, Fleminger S, Turner-Stokes L . A longitudinal, multicentre, cohort study of community rehabilitation service delivery in long-term neurological conditions. BMJ Open. 2014; 4(2):e004231. PMC: 3939653. DOI: 10.1136/bmjopen-2013-004231. View

Soberg H, Moksnes H, Anke A, Roise O, Roe C, Aas E . Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study. JMIR Res Protoc. 2021; 10(4):e25980. PMC: 8082380. DOI: 10.2196/25980. View

Kamenov K, Mills J, Chatterji S, Cieza A . Needs and unmet needs for rehabilitation services: a scoping review. Disabil Rehabil. 2018; 41(10):1227-1237. DOI: 10.1080/09638288.2017.1422036. View

Mitsch V, Curtin M, Badge H . The provision of brain injury rehabilitation services for people living in rural and remote New South Wales, Australia. Brain Inj. 2014; 28(12):1504-13. DOI: 10.3109/02699052.2014.938120. View

10.

Sirois M, Dionne C, Lavoie A . Regional differences in rehabilitation needs, rehabilitation access, and physical outcomes among multiple trauma survivors. Am J Phys Med Rehabil. 2009; 88(5):387-98. DOI: 10.1097/phm.0b013e31819c592f. View

11.

Turner-Stokes L, McCrone P, Jackson D, Siegert R . The Needs and Provision Complexity Scale: a multicentre prospective cohort analysis of met and unmet needs and their cost implications for patients with complex neurological disability. BMJ Open. 2013; 3(2). PMC: 3586084. DOI: 10.1136/bmjopen-2012-002353. View

12.

Giummarra M, Simpson P, Gabbe B . Pain, Anxiety, and Depression in the First Two Years Following Transport-Related Major Trauma: A Population-Based, Prospective Registry Cohort Study. Pain Med. 2019; 21(2):291-307. DOI: 10.1093/pm/pnz209. View

13.

Shiner C, Vratsistas-Curto A, Bramah V, McDonell K, Mahoney A, Sweeney S . Assessing unmet rehabilitation needs and the feasibility of a telehealth rehabilitation consultation service for road trauma survivors recently discharged from hospital. Disabil Rehabil. 2021; 44(15):3795-3804. DOI: 10.1080/09638288.2021.1887377. View

14.

Soberg H, Bautz-Holter E, Roise O, Finset A . Long-term multidimensional functional consequences of severe multiple injuries two years after trauma: a prospective longitudinal cohort study. J Trauma. 2007; 62(2):461-70. DOI: 10.1097/01.ta.0000222916.30253.ea. View

15.

Moksnes H, Schafer C, Rasmussen M, Soberg H, Roise O, Anke A . Factors associated with discharge destination from acute care after moderate-to-severe traumatic injuries in Norway: a prospective population-based study. Inj Epidemiol. 2023; 10(1):20. PMC: 10099012. DOI: 10.1186/s40621-023-00431-y. View

16.

Bouman A, Hemmen B, Evers S, Van de Meent H, Ambergen T, Vos P . Effects of an Integrated 'Fast Track' Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands. PLoS One. 2017; 12(1):e0170047. PMC: 5226800. DOI: 10.1371/journal.pone.0170047. View

17.

Jacob L, Cogne M, Tenovuo O, Roe C, Andelic N, Majdan M . Predictors of Access to Rehabilitation in the Year Following Traumatic Brain Injury: A European Prospective and Multicenter Study. Neurorehabil Neural Repair. 2020; 34(9):814-830. DOI: 10.1177/1545968320946038. View

18.

MacKenzie E, Rivara F, Jurkovich G, Nathens A, Frey K, Egleston B . A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006; 354(4):366-78. DOI: 10.1056/NEJMsa052049. View

19.

Andelic N, Roe C, Tenovuo O, Azouvi P, Dawes H, Majdan M . Unmet Rehabilitation Needs after Traumatic Brain Injury across Europe: Results from the CENTER-TBI Study. J Clin Med. 2021; 10(5). PMC: 7959119. DOI: 10.3390/jcm10051035. View

20.

Forslund M, Borgen I, Karic T, Kleffelgard I, Hauger S, Lovstad M . Validity of the Norwegian Version of the Needs and Provision Complexity Scale (NPCS) in Patients with Traumatic Brain Injury and Atraumatic Subarachnoid Hemorrhage. J Clin Med. 2024; 13(3). PMC: 10856215. DOI: 10.3390/jcm13030752. View