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.
Materials and methods. A prospective observational study was conducted. Intubated and ventilated males and females with penetrating trunk trauma [SV group (MV < 5 days; n = 13), LV group (MV ≥ 5 days; n = 29)] were recruited from four ICUs. Dynamometry, lung function tests, six minute walk distance (6MWD), oxygen uptake and quality of life (SF-36) were recorded over a six month period following discharge. Results were compared with a healthy control group (n=40).
Results. In LV group, 6MWD was reduced vs. controls at one (p = 0.00) and three months (p = 0.00). Morbidity correlated with 6MWD at three (p = 0.03) and six-months (p = 0.02) and there was a reduction in strength at one, three and six months relative to SV group and controls (p = 0.00 – 0.04). In addition ICU and hospital LOS correlated with muscle strength at one and three months for these subjects. SF-36 physical health domains were significantly reduced for LV group subjects up to six months compared to SV group and controls (p = 0.00 – 0.02).
Conclusion. SV group subjects recovered adequately and spontaneously within three months of discharge. LV group subjects however had significant limitations in exercise capacity, muscle strength and physical components of QOL up to six months after discharge. Persistent impairment of function is related to duration of illness and immobility.