R. Manzano-Nunez1, J. P. Herrera-Escobar1, A. Toppo3, D. Blake2, N. Levy-Carrick5, T. DeRoon-Cassini4, G. Velmahos6, G. Kasotakis2, A. Salim1, A. Haider1, D. Nehra1 1Brigham And Women’s Hospital,Surgery,Boston, MA, USA 2Boston University,School Of Medicine,Boston, MA, USA 3Tufts Medical Center,Boston, MA, USA 4University Of Wisconsin,Madison, WI, USA 5Brigham And Women’s Hospital,Psychiatry,Boston, MA, USA 6Massachusetts General Hospital,Surgery,Boston, MA, USA
Introduction: Social capital (SC) refers to the quality and quantity of social relations. Bonding SC refers to close relationships between family members or good friends. An individuals' health outcomes are known to be closely associated with individual-level SC, but the effect of SC after trauma is not known. We aim to determine the association between individual level bonding SC and long-term outcomes after injury.
Methods: Adult trauma patients with an ISS ≥9, admitted to one of three Level I Trauma Centers between 2015-2018 were contacted by phone 6 and 12 months post-injury. Patients were asked to complete an interview to assess their Health-Related Quality of Life (HRQoL) using the 12-item Short Form Survey (SF-12) and the validated Trauma Quality of Life (TQoL) survey. As a part of the TQoL survey all patients were asked to respond on a 5-point Likert scale to the following question: “My injuries have negatively changed my relationships with my family, friends, or intimate partner.” We used responses to this question as a proxy of Bonding SC. Respondents who chose strongly agree/agree and strongly disagree/disagree were considered to have weak and strong bonding SC respectively. Multivariable adjusted linear regression models were used to determine independent cross-sectional associations between weak Bonding SC and HRQoL.For the subset of patients that completed the survey at 6 and 12 months post-injury longitudinal analyses were conducted to evaluate recovery trajectories.
Results: A total of 609 patients completed the phone screen at 6 months post-injury. Of these, 480 were classified as having strong bonding SC and 129 as having weak bonding SC. Patients with weak bonding SC were significantly younger [52±21.2 vs 61±19.7years; p<0.0001] and had significantly higher ISS [15.1±7 vs 13.7±6.8; p=0.03]. After multivariable linear regression, weak bonding SC was an independent predictor for both worse mental (β=-14.34, 95% CI: -16.57 to -12.11; p<0.001) and physical health (β=-6, 95% CI: -8.32 to -3.69; p<0.001) 6 months post-injury. Of the 609 patients recruited, 229 patients were successfully followed at 12 months post-injury. Of these 229 patients, 175 were classified as having strong bonding SC and 54 as having weak bonding SC. Longitudinal analyses showed that there were significant differences in recovery trajectories between individuals with strong bonding SC when compared to those with weak bonding SC with respect to mental (p=0.005) and physical health (p=0.037) (Figure).
Conclusion: Identifying individuals with deficient close social relationships during their follow-up after trauma may help guide interventions to improve their long-term recovery.
