Ann Surg Treat Res.  2024 Nov;107(5):274-283. 10.4174/astr.2024.107.5.274.

The last chain of trauma survival: development of a scale for trauma-rehabilitation linkage in South Korea using a systematic review and expert consensus

• Lee SA
• Joo YJ
• Chang SY
• Cho JW
• Chun SW
• Kwon J
• Kong HH
• Lee KH
• Lee GJ
• Lee GJ
• Chang YR

• KMID: 2560741
• DOI: http://doi.org/10.4174/astr.2024.107.5.274

Abstract

Purpose
There is a high possibility of trauma patients being referred to an unsuitable medical institution for their rehabilitation treatment since the decision is made by them. This study sought to develop a standardized scale to evaluate the need for specialized rehabilitation in patients with multiple traumas and evaluate the effectiveness of the developed scale.
Methods
This study employed a systematic review of existing literature to inform the development of a specialized rehabilitation evaluation scale. An expert panel consisting of trauma surgeons, orthopedic surgeons, and rehabilitation medicine physicians collaborated to create a discharge-planning checklist by assessing the need for specialized rehabilitation. The checklist was validated using retrospective data from trauma patients treated at Seoul National University Hospital.
Results
We identified 12 studies, providing factors influencing the discharge location and rehabilitation needs of trauma patients. The checklist was developed through expert consensus and comprised 3 criteria: discharge feasibility to specialized rehabilitation facilities, diagnostic eligibility for specialized rehabilitation, and functional assessment. Validation of the checklist demonstrated that the percentage agreement, likelihood ratio of a positive test, and Cohen’s kappa value were 82.1%, 5.21, and 0.375, respectively when comparing whether the checklist was met and the actual discharge location, indicating its effectiveness.
Conclusion
This study established standardized criteria for assessing the need for specialized rehabilitation in trauma patients, offering a practical tool for clinical use. Implementation of this assessment scale has the potential to improve the trajectory of trauma survivors by facilitating access to appropriate rehabilitation services.

Keyword

Wounds and injuries; Patient discharge; Patient selection; Rehabilitation

Figure

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  Fig. 1 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram showing the selection of articles for review.

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  Fig. 2 Checklist regarding the need for specialized rehabilitation for trauma patients. GCS, Glasgow Coma Scale; FAC, functional assessment criteria; VRE, vancomycin-resistant Enterococcus; CRE, carbapenem-resistant Enterobacteriaceae.

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