Session X - Polytrauma II


Sat., 10/22/05 Polytrauma II, Paper #44, 9:24 am

Influence of Workers Compensation Eligibility upon Functional Recovery 10 to 28 Years after Polytrauma

Boris A. Zelle, MD1,2; Martin Panzica, MD1;
Christian A. Krettek, MD, FRACS1; Nicola A. Sittaro, MD3;
Hans C. Pape, MD1; (all authors a-Hannover-Re)
1Department of Trauma Surgery, Hannover Medical School,
Hannover, Germany;
2Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA;
3Hannover-Re, Department for Epidemiological Research, Hannover, Germany

Purpose: Previous studies have shown that work-related injuries are often associated with inferior outcomes. Most of these studies, however, have focused on single injuries with relatively short follow-up periods. It is uncertain whether these results can be extrapolated to long-term outcomes following polytrauma. Accordingly, the aim of this study was to evaluate the long-term functional recovery following polytrauma, using a minimum follow-up of 10 years, and to compare the outcomes between work-related and nonwork-related injuries.

Methods: 637 polytrauma patients were evaluated on an outpatient basis by a trauma surgeon using a self-administered patient questionnaire and a standardized physical examination. The average follow-up was 17.5 years (range, 10 to 28; the average Injury Severity Score was 20.7 (range, 4 to 54). Main outcome measurements included the Hannover Score for Polytrauma Outcome (HASPOC), the 12-Item Short-Form Health Survey (SF-12), requirement for medical aids and devices, physical disability, return to work, length of rehabilitation, and the subjective satisfaction with the rehabilitation status.

Results: A multivariate analysis, with adjustments for age, gender, injury severity, and injury pattern, demonstrated that work-related injuries resulted in significantly inferior outcomes as measured by HASPOC, SF-12, requirement for medical aids and devices, length of rehabilitation, and return to work (P<0.05).

Conclusion/Significance: Polytrauma patients receiving workers' compensation achieve significantly inferior subjective and objective long-term outcomes than other patients. The obtained results demonstrate that psychosocial variables such as insurance status have a significant impact on the functional recovery following polytrauma. We suggest that psychosocial support may further improve outcomes in these patients.


If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.