CRASH OUTCOMES AND PSYCHOSOCIAL EFFECTS (C.O.P.E.)

摘要

The social, physical, economic and psychological consequences of injury resulting from motor vehicle crashes often involve a lengthy recovery process for the patient and his family. Within the Crash Injury Research and Engineering Network (CIREN), a multicenter study investigating all aspects of automotive crashes, quality of life issues are viewed as important determinants of injury outcome. Patients at a Level I trauma center were interviewed shortly after admission and at six months and one-year post trauma to assess physical, cognitive, social and behavioral outcomes. Ninety patients completed the interview process through one-year follow-up. Study patients were primarily women (61%); mean age was 37 years. The majority of patients were drivers, of whom 71% were belted with airbag deployment. Sixty-eight percent were culpable for their crash. Over 70% of patients had a lower extremity injury and 33% had a traumatic brain injury. Only 16% had less than a high school education and 63% were working full time prior to the crash. Of those employed pre injury, 61% had returned to work by six months and 70% at one year. One-half of the patients experienced ambulation difficulties with decreased mobility at six months; 39% had difficulty ambulating at one year. Thirty-six percent of the patients experienced either a history of depression or were depressed at the time of admission to the trauma center. Overall, 50% of the patients reported feelings of depression at 6 months and 43% reported feeling depressed and lacking motivation at one year. However, of those patients with a history of depression, 79% were depressed at 6 months post-trauma and 36% exhibited symptoms of post-traumatic stress disorder at six months. Thirty-four percent of all patients reported cognitive problems (e.g., difficulty concentrating/problem solving, recall, etc.) at six months and 28% reported continued problems noticeable to themselves and family members at one year. Behavioral problems (e.g., personality changes) were experienced by 40% of patients at six months and almost one-quarter of patients at one year.