Background : The purpose of this study was to evaluate the validity of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) for examining outcomes after multiple trauma and to investigate whether the addition of items selected to measure cognitive function could improve the sensitivity of the SF-36 for identifying differences in outcomes for patients with and without head injury.
Methods : One thousand two hundred thirty patients discharged from 12 trauma centers were interviewed 1 year after injury. The interview included the SF-36 supplemented with four items chosen to assess cognitive function.
Results : The resulting cognitive function scale is internally consistent and measures a component of health that is independent of the dimensions incorporated in the SF-36. It correlates well with established measures of brain injury severity and discriminates among patients with and without brain injury.
Conclusion : This study underscores the need to supplement the SF-36 with a measure of cognitive function when evaluating outcome from multiple trauma involving head injury. Further studies are needed to validate the specific items chosen for measuring cognitive function.
From the Center for Injury Research and Policy (E.J.M., M.L.M.), The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, Department of Rehabilitation Medicine (J.F.D.), Thomas Jefferson University, Philadelphia, Trauma Systems Foundation (C.F.-S.), Mechanicsburg, Departments of Orthopaedics (G.S.G.) and Neurosurgery (D.W.M.), University of Pittsburgh, Pittsburgh, and Department of Surgery (C.W.S.), University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
Submitted for publication July 28, 2000.
Accepted for publication November 10, 2001.
Supported by Cooperative Agreement DTNH22-94-H-06014 from the National Highway Traffic Safety Administration of the U.S. Department of Transportation and grant R49/CCR302486 from the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.
Presented at the 60th Annual Meeting of the American Association for the Surgery of Trauma, October 11–15, 2000, San Antonio, Texas.
Address for reprints: Ellen J. MacKenzie, PhD, The Johns Hopkins Center for Injury Research and Policy, 624 North Broadway, Room 554, Baltimore, MD 21205; email: emackenz@jhsph.edu.
