In his doctoral thesis, UMC Utrecht rehabilitation doctor Herman Holtslag concludes that other diseases determine the recovery of people admitted with serious to very serious injuries to the trauma center after an accident. Of these patients, 60 percent were back at work fifteen months later. Twenty percent only returned to work part-time or for fewer hours than they had originally worked, and another 20 percent of the patients did not return to work at all.
Holtslag surveyed the recovery of 335 victims following serious trauma. Seventy-five percent of those in the group were men, with an average age of 37; of the victims, 70 percent had been involved in traffic accidents. Along with the immediate effects of the accident and other diseases, after more than a year, known factors such as age and type of injury determined recovery. Although the percentage of permanent disability was low at 4 percent, it is interesting to note that the majority of people reported problems at work, at home, and during leisure activities. Because of the new Work and Income according to Labor Capacity Act (WIA Act), people with partial disability (up to 35 percent) will no longer be entitled to benefits.
In a group of 507 accident victims (including the patients mentioned above), Rob Lichtveld studied the effect of treatment at the accident scene. Lichtveld is medical affairs manager of the “Utrecht Regional Ambulance Service.” He found that performing more procedures at the scene of the accident did not result in lower death rates or better quality of life, nor did incorrect diagnoses by ambulance personnel have any negative effects. Elderly people, though, did have higher death rates.
As a result, Lichtveld argues for transferring patients to the trauma center as soon as possible, and only doing limited examination at the accident scene. His findings have already led to a number of changes to the national ambulance protocols. For example, stabilizing patients and giving oxygen are extremely important, while administering an intravenous drip is probably less so.
Good trauma care is important because children, youths, and young adults up to the age of 44 lose the largest number of years of life as a result of accidents. For this reason, according to Holtslag and Lichtveld, it is essential to integrate long-term research into health care, just as it is to improve care in the chain of prevention, acute care, rehabilitation, and occupational reintegration.
Herman Holtslag and Rob Lichtveld received their PhDs on January 25 from Utrecht University.
For more information (in Dutch, with some English content):
www.traumaresearch.nl For more information: UMC Utrecht, In- en Externe Communicatie
Linda Minnen en Annette Aarts, tel. 088 75 585 80 or 088 75 563 71