Redefining Trauma Recovery



Since 2016, the FORTE project has produced and disseminated several important findings as well as demonstrating that routine collection of long-term trauma outcomes is feasible. Among these findings are that patient factors (age, gender, race, education) are more important than injury-related factors (injury severity or location) in predicting long-term outcomes and that poor long-term outcomes after injury tend to be associated with each other within and across different health domains (mental, physical, social).

RESTORE (Remote Evaluation of Symptoms and Trauma Outcomes in REcovery)

In the United States, improvements in both medical technology and trauma clinical care have reduced in-hospital deaths from traumatic injury to fewer than 4%. However, what happens to the 96% of trauma survivors when they go home is largely unknown.

With funding from the Stepping Strong Center for Trauma Innovation, Juan Herrera-Escobar, MD, MPH, and colleagues will analyze smartphone use data, sensors, and ecologic momentary assessments to learn about trauma survivors’ recovery experience after hospital discharge. Specifically, RESTORE will use this cutting-edge technology, known as smartphone-based digital phenotyping, to track trauma survivors’ physical activity, mobility, pain, sleep, social participation, return to work, and community integration. This information will allow us to better understand what happens to survivors of traumatic injury after they leave the hospital and to develop ways to improve long-term recovery in trauma.


MENTAL HEALTH | Research on the patient’s self-reported state of mind and emotional wellness after injury

Mental Health Burden After Injury: It’s About More than Just Posttraumatic Stress Disorder Annals of Surgery 2020

Resilience and long-term outcomes after trauma: An opportunity for early intervention? Journal of Trauma and Acute Care Surgery 2019

A multicenter study of post-traumatic stress disorder after injury: Mechanism matters more than injury severity Surgery 2018


PHYSICAL HEALTH | Research on the long-term condition of patient’s body after injury taking into consideration everything from persistent symptoms to functionality

The impact of in-hospital complications on the long-term functional outcome of trauma patients: A multicenter study Surgery 2019

It still hurts! Persistent pain and use of pain medication one year after injury The American Journal of Surgery 2019

Association of pain after trauma with long-term functional and mental health outcomes Journal of Trauma and Acute Care Surgery 2018


SOCIAL HEALTH & QUALITY OF LIFE | Research on the patient’s global functioning and ability to carry out their role within social settings such as work, family, and community

Patient-reported Outcomes at 6 to 12 Months Among Survivors of Firearm Injury in the United States Annals of Surgery 2020

Long-term social dysfunction after trauma: What is the prevalence, risk factors, and associated outcomes? Surgery 2019

Factors Associated With Long-Term Outcomes After Injury: Results of the Functional Outcomes and Recovery After Trauma Emergencies (FORTE) Multicenter Cohort Study Annals of Surgery 2018


HEALTH DISPARITIES | Research on health disparities in long-term trauma outcomes including race, gender, ethnicity, and socioeconomic status

Lower education and income predict worse long-term outcomes after injury Journal of Trauma and Acute Care Surgery 2019

Racial disparities in post-discharge healthcare utilization after trauma The American Journal of Surgery 2019


METHODS OF DATA COLLECTION | Research on measurement tools and techniques for routine collection of long-term patient-centered data

Development and validation of a revised trauma-specific quality of life instrument Journal of Trauma and Acute Care Surgery 2020

Routine inclusion of long-term functional and patient-reported outcomes into trauma registries: The FORTE project Journal of Trauma and Acute Care Surgery 2017


HEALTH SERVICES | Research on the use, costs, quality, accessibility, delivery, organization, financing, and long-term outcomes of health care services after injury

Reduced chronic pain: Another benefit of recovery at an inpatient rehabilitation facility over a skilled nursing facility? The American Journal of Surgery 2020

Racial disparities in post-discharge healthcare utilization after trauma The American Journal of Surgery 2019