Effects of an Integrated 'Fast Track' Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands

Ans I. E. Bouman*, Bea Hemmen*, Silvia M. A. A. Evers, Henk van de Meent, Ton Ambergen, Pieter E. Vos, Peter R. G. Brink, Henk A. M. Seelen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Web of Science)

Abstract

Objectives

The effects on health related outcomes of a newly-developed rehabilitation program, called `supported Fast Track multi-trauma rehabilitation service' (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual).

Methods

Prospective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score >16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures. The Fast Track program involved: integrated coordination between trauma surgeon and rehabilitation physician, shorter stay in hospital with faster transfer to a specialized trauma rehabilitation unit, earlier start of multidisciplinary treatment and 'non-weight bearing' mobilization. Primary outcomes were functional status (FIM) and quality of life (SF-36) measured through questionnaires at baseline, 3, 6, 9 and 12 months post-trauma. Outcomes were analyzed using a linear mixed-effects regression model.

Results

The FIM scores significantly increased between 0 and 3 months (p

Conclusion

Both Fast Track and Care as Usual rehabilitation programs were effective in that multi trauma patients improved their functional status and quality of life. A faster (maximum) recovery in functional status was observed for Fast Track at 6 months compared to 9 months for Care as Usual. At twelve months follow-up no differential effects between treatment conditions were found.

Original languageEnglish
Article number0170047
Number of pages16
JournalPLOS ONE
Volume12
Issue number1
DOIs
Publication statusPublished - 11 Jan 2017

Keywords

  • QUALITY-OF-LIFE
  • FUNCTIONAL INDEPENDENCE MEASURE
  • SF-36 HEALTH SURVEY
  • MAJOR TRAUMA
  • LONGITUDINAL COHORT
  • FOLLOW-UP
  • CARE
  • INJURIES
  • CONSEQUENCES
  • VALIDATION

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