The mind continues to matter: psychologic and physical recovery 5 years after musculoskeletal trauma

Alasdair George Sutherland, Stuart Suttie, David A. Alexander, James D. Hutchison

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: Posttraumatic psychopathology may complicate recovery from musculoskeletal injury. This article details the 5-year follow-up of a cohort study examining the relationship between posttraumatic psychopathology and recovery after musculoskeletal trauma.

Design: A prospective cohort study of patients with musculoskeletal injuries (Grampian Trauma Outcomes Study) assessed 5 years after their injury.

Setting: Orthopaedic trauma unit, Level I equivalent.

Patients: One hundred four of the initial group of 200 patients with musculoskeletal injuries.

Intervention: Trauma care and prospective evaluation of physical and psychologic recovery.

Main Outcome Measures: Development of psychopathology (measured by the General Health Questionnaire [GHQ]) and functional outcome (measured by Short Form-36 [SF-36] and Musculoskeletal Function Assessment [MFA]).

Results: Follow-up at 5 years was 104 patients (52%). GHQ caseness was predictive of physical dysfunction (SF-36, MFA), which had not returned to baseline levels by 5 years. Although injury severity was strongly predictive of psychological disturbance (GHQ caseness) at 5 years, linear regression analysis demonstrated that GHQ score was an important predictor of outcome, whereas Injury Severity Score contributed very little.

Conclusions: Psychologic disturbance after musculoskeletal trauma is related to adverse functional outcome. This is not influenced by preinjury state, but constitutes a sustained posttraumatic effect that is only weakly related to severity of injury.

Original languageEnglish
Pages (from-to)228-232
Number of pages5
JournalJournal of Orthopaedic Trauma
Volume25
Issue number4
DOIs
Publication statusPublished - Apr 2011

Keywords

  • activities of daily living
  • adolescent
  • adult
  • aged
  • comorbidity
  • female
  • follow-up studies
  • humans
  • incidence
  • injury severity score
  • male
  • mental disorders
  • middle aged
  • musculoskeletal system
  • outcome assessment (health care)
  • prospective studies
  • quality of Life
  • recovery of function
  • United States
  • wounds and injuries
  • stress disorders
  • major trauma
  • traffic accidents
  • orthopedic trauma
  • posttraumatic
  • multiple trauma/complications
  • treatment outcome
  • posttraumatic-stress-disorder
  • function assessment instrument
  • general health questionnaire
  • motor-vehicle accidents
  • term-follow-up, , ,
  • quality-of-life

Cite this

The mind continues to matter : psychologic and physical recovery 5 years after musculoskeletal trauma. / Sutherland, Alasdair George; Suttie, Stuart; Alexander, David A.; Hutchison, James D.

In: Journal of Orthopaedic Trauma, Vol. 25, No. 4, 04.2011, p. 228-232.

Research output: Contribution to journalArticle

Sutherland, Alasdair George ; Suttie, Stuart ; Alexander, David A. ; Hutchison, James D. / The mind continues to matter : psychologic and physical recovery 5 years after musculoskeletal trauma. In: Journal of Orthopaedic Trauma. 2011 ; Vol. 25, No. 4. pp. 228-232.
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N2 - Objectives: Posttraumatic psychopathology may complicate recovery from musculoskeletal injury. This article details the 5-year follow-up of a cohort study examining the relationship between posttraumatic psychopathology and recovery after musculoskeletal trauma.Design: A prospective cohort study of patients with musculoskeletal injuries (Grampian Trauma Outcomes Study) assessed 5 years after their injury.Setting: Orthopaedic trauma unit, Level I equivalent.Patients: One hundred four of the initial group of 200 patients with musculoskeletal injuries.Intervention: Trauma care and prospective evaluation of physical and psychologic recovery.Main Outcome Measures: Development of psychopathology (measured by the General Health Questionnaire [GHQ]) and functional outcome (measured by Short Form-36 [SF-36] and Musculoskeletal Function Assessment [MFA]).Results: Follow-up at 5 years was 104 patients (52%). GHQ caseness was predictive of physical dysfunction (SF-36, MFA), which had not returned to baseline levels by 5 years. Although injury severity was strongly predictive of psychological disturbance (GHQ caseness) at 5 years, linear regression analysis demonstrated that GHQ score was an important predictor of outcome, whereas Injury Severity Score contributed very little.Conclusions: Psychologic disturbance after musculoskeletal trauma is related to adverse functional outcome. This is not influenced by preinjury state, but constitutes a sustained posttraumatic effect that is only weakly related to severity of injury.

AB - Objectives: Posttraumatic psychopathology may complicate recovery from musculoskeletal injury. This article details the 5-year follow-up of a cohort study examining the relationship between posttraumatic psychopathology and recovery after musculoskeletal trauma.Design: A prospective cohort study of patients with musculoskeletal injuries (Grampian Trauma Outcomes Study) assessed 5 years after their injury.Setting: Orthopaedic trauma unit, Level I equivalent.Patients: One hundred four of the initial group of 200 patients with musculoskeletal injuries.Intervention: Trauma care and prospective evaluation of physical and psychologic recovery.Main Outcome Measures: Development of psychopathology (measured by the General Health Questionnaire [GHQ]) and functional outcome (measured by Short Form-36 [SF-36] and Musculoskeletal Function Assessment [MFA]).Results: Follow-up at 5 years was 104 patients (52%). GHQ caseness was predictive of physical dysfunction (SF-36, MFA), which had not returned to baseline levels by 5 years. Although injury severity was strongly predictive of psychological disturbance (GHQ caseness) at 5 years, linear regression analysis demonstrated that GHQ score was an important predictor of outcome, whereas Injury Severity Score contributed very little.Conclusions: Psychologic disturbance after musculoskeletal trauma is related to adverse functional outcome. This is not influenced by preinjury state, but constitutes a sustained posttraumatic effect that is only weakly related to severity of injury.

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