CoRPS Center of Excellence

Research of the Department Medical and Clinical Psychology is embedded in CoRPS.

Trauma

Until now, the primary focus in trauma care has been on physical treatment and physical rehabilitation and the traditional outcome parameter to measure quality of care in trauma registries, is in-hospital mortality. In other words, the treatment of patients is almost exclusively based on the possibilities afforded by technologies, minimal invasive radiological techniques, surgical techniques, and surgical abilities. Aspects such as the age of patients, cognitive, behavioural, emotional and social damage, the presence of co-morbidities, and the complexity of trauma in relation to the patients' view of his/her life and wishes are mistakenly considered to be of lesser importance. Fortunately, it is becoming increasingly clear that the way trauma care is provided to patients is strongly associated with patients' QOL and return to work, not only in severely injured patients, but also after single fractures, such as ankle [70] and wrist fractures[69] and vertebral body compression fractures [42, 73].

The long-term effects of injuries on older patients and severely injured patients in terms of clinical outcome, QOL, socioeconomic consequences, morbidity and mortality is the focus of this research program. In addition to these outcome measures, cost-effectiveness studies will be part of the program.
A major aim of this research program is to develop risk profiles to be used by trauma teams in decision making in patient care. Therefore, the focus will be on risk factors for patient morbidity, mortality, poor QOL, health care consumption, and rates of return to work. The specific focus in this program is on finding substantial risk factors and, subsequently, examining who is at risk for negative outcomes from surgical treatment and subsequently discussing this with the patient. It is expected that risk profiling based not only on medical data but also on psychosocial data (risk factors) and patient-reported outcomes will change decision making in trauma care. It will result in the systematic collection of data on morbidity, mortality, QOL, health care consumption, and return to work in all trauma patients. It could influence at least (i) the choice between conservative versus (minimal-)invasive treatment; (ii) the logistics in trauma management; (iii) the centralization of trauma care; (iv) health care costs; and (v) the knowledge of trauma patient morbidity, mortality and QOL.

Within the trauma research program the focus is on the following five areas: 1) risk factors for negative outcomes in patients with complicated fractures, 2) shared decision making in trauma patients with comorbidity, 3) risk factors for mortality, morbidity, and quality of life in elderly trauma patients (age 75+), 4) severely injured patients (multitrauma), and 5) patients with severe brain damage (neurotrauma).