Session X - Polytrauma II

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

Boris A. Zelle, MD^1,2; 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.