Kleppel JB, Lincoln AE, Winston FK: Assessing head-injury survivors of motor vehicle crashes at discharge from trauma care. Am J Phys Med Rehabil 2002;81:114–122.
This study examines the needs at discharge from acute care to home of trauma patients with head injuries resulting from motor vehicle crashes.
A retrospective case series was conducted by using the 1997 trauma registry to identify eligible adults. Selected variables were abstracted from medical records and hospital databases.
Thirty-four cases were reviewed. At discharge, rehabilitative needs associated with musculoskeletal injury, brain injury, skin integrity, and pain management were identified, with 55% of patients having needs in two or more domains. Although all patients were referred for follow-up appointments, only 62% of patients returned for trauma-related follow-up within this institution. After initial hospitalization, twenty-four percent of patients were seen in the emergency department, and 6% had trauma-related readmissions.
This study documents the multidimensional needs of this group of survivors of motor vehicle trauma with head injury who were discharged to home. Findings suggest that mobility skills were formally assessed more often than either self-care skills or cognition, possibly resulting in an underestimate of the amount of disability
experienced by this group. There seems to be a gap in continuity of care from hospital to the outpatient setting as evidenced by missed follow-up appointments. Models for continuity-focused trauma care with rehabilitative components are needed.