• Meaghan L O'Donnell, Mark Creamer, Peter Elliott, Christopher Atkin, and Thomas Kossmann.
• Australian Centre for Posttraumatic Mental Health, National Trauma Research Institute, University of Melbourne, Melbourne, Australia. mod@unimelb.edu.au
• J Trauma. 2005 Dec 1; 59 (6): 1328-34; discussion 1334-5.

BackgroundThe factors that determine quality of life (QOL) and disability after traumatic injury are poorly understood. This study identified the unique contributions that characteristics about the injury/hospital admission and acute psychological adjustment make in determining 12-month role-related disability and QOL.MethodsConsecutive admissions (n = 363) to a Level I trauma service were assessed just before discharge and followed up at 12 months. Structural equational modeling was used to examine the relationships between the acute factors and 12-month outcomes.ResultsCharacteristics of the individual's injuries measured in the acute setting significantly predicted 12-month disability but only indirectly predicted 12-month QOL. An individual's acute psychological response directly predicted both the level of disability and QOL at 12 months.ConclusionsBoth characteristics about an individual's injury and acute psychological responses play important roles in determining later QOL and role-related disability outcomes. Trauma care systems must consider both physical and psychological injury to offer effective and comprehensive healthcare management.

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