In the United States, injuries, caused intentionally and accidentally, constitute the leading cause of death among all persons aged 1 to 38, and is the fourth leading cause of death among all age groups, accounting for 1 out of 18 fatalities and claiming more than 105,718 lives per year (National Safety Council 1984). Over the last 10-20 years the injury death rate has been declining, due to advances in injury control and trauma care. In spite of the significant numbers of individuals who are injured and survive, very little is known about the characteristics of resulting disability or about the factors, in addition to severity of injury, that may affect the extent and rate of recovery. Nor is much known about the mix of health and rehabilitation services needed and utilized by this large and vulnerable population. It is the goal of this proposed research project to investigate the long-term (4 year) effects of trauma for a group of moderate and severely head injured patients and to compare them to a group of severe extremity injured patients. This project, which is an extension of a prospective longitudinal study of the functional status of trauma patients following discharge, will re-interview a population of trauma survivors 4 years post-discharge. This study will investigate four year outcomes of physical, psychosocial and cognitive function. Specifically the aims of the study are: 1. to describe the long term physical, cognitive, and psychosocial disabilities of head trauma survivors as compared to severe extremity injured survivors and to compare the extent of recovery with that noted at 6 and 12 months post-injury. 2. to investigate factors which are associated with improved physical, cognitive, and psychosocial function and the ability to resume ones pre-injury activities (return to work, school, etc.) and 3. to document the perceived need for the use of health and human services in a trauma population at four years post-discharge.
