Adherence to Guidelines for Acute Rehabilitation in the Norwegian Trauma Plan.
Christoph Schäfer, Håkon Øgreid Moksnes, Mari S Rasmussen and 12 others
PMID 37366570WHAT IT FOUND
Adherence to Norwegian trauma rehabilitation guidelines was poor.
Only 18% of ICU patients stayed 3+ days received a specialist assessment within 72 hours. Just 22% of all patients transferred directly to specialized rehabilitation, leaving many with severe injuries without timely acute care.
Key findings
01Only 18% of patients who stayed in the ICU for 3 or more days had a documented assessment by a physical medicine and rehabilitation physician within 3 days of admission.
0270% of participants with at least a 2-day ICU stay received therapist intervention, but multidisciplinary care was provided to only 31% of those with severe injuries.
03Only 22% of all participants were transferred directly from acute trauma care to a specialized rehabilitation unit, with rates dropping to 9% for those with moderate injuries.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on documented assessments in electronic records, which may understate the actual number of informal assessments that took place. Patients with psycho-social or drug problems were more likely to be non-responders or leave against medical advice, meaning this group may be underrepresented. The study was conducted in Norway, so the specific guideline adherence rates and healthcare system structures may not directly translate to other countries. Spinal cord injury patients were routinely referred to rehabilitation by other means, which may skew the data on specialist assessment and direct transfer rates for this group.
Declared interests
The authors declare no conflicts of interest. The study was approved by the Committee for Medical Research Ethics and Data Protection Officers at the participating hospitals.
The easy way to misread this
Do not assume that the low rates of direct transfer and specialist assessment reflect a lack of clinical need or that these patients are receiving adequate care elsewhere. The study found that adherence to guidelines was poor, meaning many patients with severe injuries, particularly those with extremity or moderate injuries, may not be getting the timely rehabilitation they need.