Functional Recovery and Quality of Life in Older Adults Following Trauma: A Longitudinal Study in an LMIC

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Abstract
Background: Older patients experience poorer outcomes due to factors such as frailty and comorbidities. This study examines the long‐term outcomes of injured older adult patients, focusing on trauma‐related quality of life (QoL) and functional independence in low‐ and middle‐income countries such as Pakistan. Methods: This prospective cohort included patients aged ≥ 60 admitted to two tertiary care hospitals in Karachi, Pakistan, between December 2021 and May 2023. Functional Independence Measure (FIM) and Revised Trauma‐related Quality of Life (RT‐QoL) scores were recorded at 1‐, 3‐, and 6‐month post‐discharge. Linear regression and an adjusted cumulative link model were used to evaluate factors affecting FIM and RT‐QoL at 6 months. Results: Of 3374 trauma admissions, 651 patients were aged ≥ 60 years; 288 who were alive at 6 months with follow‐up data were analyzed (mean age 69.1 years, 54% male); injuries were predominantly due to falls (69.1%) and involved extremities (72%). Age (−0.58 per year; −0.85 to −0.31) and road traffic incidents (5.59; 0.39–10.79) were associated with FIM scores at 6 months. Most patients (85%) reached modified to complete independence by 6 months. Most recovery was seen in emotional well‐being, slightly higher in females as compared to males (65.1% vs. 62.8%). There was a significant difference in recovery between females and males in functional engagement at 1 month (14.5% vs. 29.5%, p < 0.05) and 6 months (43.9% vs. 62.2%, p < 0.05). Conclusion: Older adult trauma patients who survived to 6 months largely recovered toward their pre‐injury level of functional independence, though residual disability was common and females showed lower functional engagement. High mortality among severely injured patients likely skewed results toward milder injuries. These findings underscore the need for both injury prevention and trauma system strengthening to reduce mortality, and rehabilitation services to address residual disability among survivors.
Funding Information
  • Fogarty International Center (D43TW007292)

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