Rehabilitation after moderate to severe trauma in accordance to Norwegian guidelines

Abstract

Background Severe traumatic injuries are a significant cause of long-lasting morbidity and early death, with functional and psychological consequences. As a way to prevent and mitigate this, Nasjonal Kompetansetjeneste for traumatology (NKT) revised in 2017 the national guidelines from 2007, including guidelines for best practice when it comes to rehabilitation after trauma. This study aimed to look at some of these guidelines in practice at the University Hospital of North Norway (UNN), in an acute setting and the follow-up.

Method A prospective study of 47 patients of all ages with moderate to severe trauma, defined by a New Injury Severity Score > 9, admitted to the trauma center of Northern Norway within 72 hours after injury during one year. Approximately 41 patients received follow-up at six months. Results When looking at these 47 patients it was revealed that 6% got assessed during the first 72 hours, 52% of the 21 patients who had a stay of over two days in an intensive care unit received rehabilitation in the acute phase, and 30% got transferred directly to a specialized rehabilitation unit after discharge. Furthermore, fifteen percent of those who got follow-up received assistance through ambulatory rehabilitation teams, and two patients in total received psychological follow-up. Lastly 25% of 20 had symptoms consistent with post-traumatic stress disorder, and 35% of 23 had a continuous severe disability at six months. Conclusion This study is suggesting an indication of a low percentage of patients receiving rehabilitation in accordance to the national both in the acute phase, and when looking at psychological sequela and standardized follow-up in the period after discharge. The findings from this study highlight the need for an improvement to the systems currently in use.