Effect of penetrating trunk trauma on the recovery of adult survivors: A pilot study

Abstract

Gunshot and/or stab wounds to the trunk are injuries seen in South African hospitals. Patients are managed in the intensive care unit. Prolonged mechanical ventilation with immobilization results in some degree of muscle dysfunction. Our goal was to determine if patients recover adequately spontaneously following critical illness. No formal rehabilitation programmes exist in South Africa for these patients following discharge. A prospective, observational study was conducted. Patients were recruited from three ICUs in Johannesburg. Lung function tests, dynamometry, quality of life, 6-minute-walk, and oxygen uptake tests were performed over 6 months following discharge from the hospital. The control group consisted of existing data for healthy volunteers. Distance walked during 6-minute-wallk test was significantly reduced for the study group compared to the control group (1 month [p=0.00251]; 6 months [p=0.0355]). At 1 month there was a significant reduction in quadriceps and triceps strength for the study group compared to the control group (p=0.0089; p=0.0246, respectively). Quadriceps strength remained significantly reduced for the study group (3 months [p=0.0489]). No difference in muscle strength was detected between the groups at 6 months. Actual and predicted residual volumes differed significantly for the study group (1 month [p=0.0034]; 6 months [p=0.0157]). A trend of muscle weakness (to 3 months), poor exercise capacity, and abnormal lung volumes was identified. A formal rehabilitation programme may be needed to address these disabilities.