The effect of penetrating trunk trauma and mechanical ventilation on the recovery of adult survivors after hospital discharge

Abstract

Objectives. To establish whether survivors of penetrating trunk trauma recover adequately and spontaneously following critical illness. Material and methods. A prospective observational study was conducted. Intubated and ventilated males and females with penetrating trunk trauma (SV group (mechanical ventilation (MV) <5 days, N=13), LV group (MV ≥5 days, N=29)) were recruited from four intensive care units. Dynamometry, lung function tests, 6-minute walk distance (6MWD), oxygen uptake and quality of life (QOL), assessed with the short form-36 English UK version (SF-36) questionnaire, were recorded over a 6-month period following discharge. Results were compared with a healthy control group (N=40). Results. In the LV group, 6MWD was reduced in comparison wit h controls at 1 (p=0.00) and 3 months (p=0.00) after discharge. Morbidity correlated with 6MWD at 3 (p=0.03) and 6 months (p=0.02), and there was a reduction in strength at 1, 3 and 6 months relative to the SV group and controls (p=0.00 - 0.04). In addition, intensive care unit and hospital length of stay correlated with muscle strength at 1 and 3 months for these subjects. SF-36 physical health domains were significantly reduced for LV group subjects up to 6 months compared with the SV group and controls (p=0.00 - 0.02). Conclusion. SV group subjects recovered adequately and spontaneously within 3 months of discharge. LV group subjects, however, had significant limitations in exercise capacity, muscle strength and physical components of QOL up to 6 months after discharge. Persistent impairment of function is related to duration of illness and immobility.