Functional recovery and medical costs of trauma: an analysis by type and severity of injury.

This study was designed to delineate the factors that influence the extent and rate of recovery as related to the characteristics and duration of functional limitations resulting from trauma. The study population was 597 surviving trauma patients aged 16-45 years from two trauma centers in a single state system which follow similar care protocols, and included patients with extremity, abdomen, thorax, brain, and spinal cord injuries. Of 479 trauma patients (80% of the total) who were followed for a full year, 57% had no activity restrictions, 16% had some limitation with either a major or minor physical activity, but did not have any difficulty with mobility or self care, and 27% were limited in either mobility or one of the five basic self-care activities. Further analyses show that of the 262 individuals who were working full-time before the injury, 57% had actually returned to full-time employment within the year. Factors in addition to type and severity of trauma that influence return to work were higher educational level, white collar employment, higher preinjury income, and the presence of supportive individuals among family or friends. Recovery as defined by functional status and return to full-time work is analyzed by body region and severity of the principal injury sustained.