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Predictors for Poor Outcome 10 Years or More After Multiple Orthopedic Injuries (Polytrauma)

Purpose: To identify risk factors for poor late outcome in a patient with multiple orthopedic injuries but without severe head trauma according to Pape et al.

Description

Pape et al identified predictors of poor physical and psychosocial outcome many years after multiple traumatic orthopedic injuries. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Aachen, Hannover Life RE-Insurance, the University of Pittsburgh and Sande General Hospital in Germany.


 

Patient selection: age 3 to 60 years with multiple orthopedic injuries (NISS >= 16) excluding severe head trauma

 

Key predictors of poor outcome:

(1) lower limb amputation

(2) high AIS spine score, especially with paraplegia

 

Additional factors associated with a poor outcome:

(1) 2 or more articular injuries (to major joints)

(2) combination of long bone and articular injuries

(3) other significant injuires to the pelvis and/or lower extremity

 

Some disability was related to post-traumatic degenerative arthritis and post-traumatic stress disorder (PTSD).

 

Injuries to the lower extremities had a greater impact on long-term outcome than injuries to the upper extremities.

 


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Specialty

Objective

ICD-10