Why We Need a Better Way to Track Long Term Outcomes in Trauma Patients
Alexander Ordoobadi, MD, and Geoffrey Anderson, MD, MPH, FACS, both of the Department of Surgery at Mass General Brigham, are the lead and senior authors of a paper published in the Journal of Surgical Research, “Measurement of Long-Term, Quality-of-Life Outcomes in Injury Databases.”
Q: How would you summarize your study for a lay audience?
Previous research found patients with traumatic injuries experience numerous challenges with their long-term recovery that can result in poor quality-of-life (QOL). Thess challenges can include chronic pain, inability to return to work and post-traumatic stress disorder.
Research into QOL outcomes after traumatic injuries is limited due to a lack of national data.
In this study, we systematically evaluated national injury databases to determine whether they capture long-term QOL outcomes. We found there is no standardized system for capturing long-term QOL outcomes for trauma patients in national injury databases, and most databases do not capture any QOL outcomes.
The lack of QOL outcomes results in an incomplete view of trauma system quality and limits the scope of trauma research.
Q: What question were you investigating?
We evaluated whether national injury databases systematically collect information about patients’ long-term outcomes, including post-injury QOL.
We also aimed to determine whether databases measure the full continuum of trauma care, ranging from initial prehospital care provided by emergency medical services through care in the trauma center and post-injury rehabilitation.
Q: What methods or approach did you use?
We systematically evaluated each variable in all national injury databases to determine whether they measured QOL outcomes and collected data across all phases of trauma care.
Q: What did you find?
We found that currently available national injury databases do not capture long-term QOL outcomes, except for patients with traumatic brain injuries, spinal cord injuries and burn injuries who are enrolled in specialized rehabilitation programs.
Furthermore, we found that national injury databases do not capture information across the entire continuum of trauma care.
This means information about prehospital care provided by emergency medical services is in a separate database from information about care provided in trauma centers, and these databases cannot be linked.
Q: What are the implications?
Researchers rely on large national databases to measure the quality of trauma care and evaluate new innovations to improve patient outcomes.
The lack of QOL outcomes in these databases combined with the fragmentation of data collection across phases of trauma care results in an incomplete view of trauma system quality and artificially narrows the scope of research.
Our findings suggest that national injury databases need to adopt standardized systems to measure the QOL of injury survivors.
Q: What are the next steps?
We have started to collect long-term QOL outcomes for a subset of injured patients treated at Mass General Brigham through the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project.
This project could serve as a model for a future national database that tracks long-term outcomes for injured patients.
Authorship: In addition to Ordoobadi and Anderson, Mass General Brigham authors include Kimberly Greenberg, Saba Ilkhani, Isaac Alty, Jeffrey Schneider and Juan Herrera-Escobar.
Paper cited: Ordoobadi, A., et al. Measurement of Long-Term, Quality-of-Life Outcomes in Injury Databases. Journal of Surgical Research. DOI: https://doi.org/10.1016/j.jss.2025.05.027
Funding: This work was supported by grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (90DPBU0008).
Disclosures: N/A