Article

Bio-psychosocial characteristics of patients after orthopaedic traumas
may be a strong predictor of poor outcome. The objective of this prospective
study was to assess whether the INTERMED, a measure of bio-psychosocial
complexity, identifies complex inpatients during rehabilitation including
vocational aspects with a poor outcome 1 year after discharge. METHOD: At entry,
the INTERMED scores of 118 inpatients were used to assign patients to the high or
low complexity group. A questionnaire evaluated 1 year after discharge whether
patients: (1) returned to work, (2) still have therapies, (3) take psychoactive
drugs, (4) take medication against pain and (5) were satisfied with vocational
therapy. Univariate logistic regressions identified which variables predict
INTERMED case complexity during hospitalisation as well as predictors (i.e.
INTERMED case complexity, French as preferred language, duration of the
disability, accident at work, work qualification, severity of the injury,
psychiatric co-morbidities, pain) of the five measured outcomes 1 year after
discharge. RESULTS: During hospitalisation, the high complexity group was
associated with a high prevalence of psychiatric co-morbidities, a higher level
of pain and a weaker perception of treatment effects. One year after discharge,
the INTERMED was the sole variable to predict all outcomes. CONCLUSION: The INTERMED identifies complex patients during vocational rehabilitation after
orthopaedic trauma and is a good predictor of poor outcome 1 year after discharge.

Langue : ANGLAIS