Catastrophic injury is a serious debilitating and life-altering event that generally involves permanent disability, long-term care, or death. While the most obvious ramifications of the injury, such as loss of limbs, paralysis, or cognitive function can be traced to the musculoskeletal or neurologic systems, the internal organ systems are also often affected by a catastrophic injury and the resulting dysfunction may contribute significantly to the prognosis and level of disability.
Unfortunately, the nature and scope of the injury to the internal organs is more difficult to determine since the pathology is not outwardly visible, and there is a lack of understanding of the physiology of internal organ function, especially when multiple organ systems are involved.
In addition to the musculoskeletal and neurologic systems, serious injury may affect the following internal organs:
- Chest wall/ribs
In the majority of catastrophic injury cases, the function of these organs will contribute significantly to the level of dysfunction and disability resulting from the injury and generally determines the length of time, or life expectancy, that the injured party will survive following the injury.
On occasion, the pathology in these organs may actually predate the injury. Therefore, organ function pre- and post-injury must be evaluated to assess whether or not the pathology has been caused and/or aggravated by the injury and is contributing to the level of disability.
Life expectancy is typically evaluated using Social Security tables, which are used by actuarials to calculate the economic value of catastrophic injury cases. However, a physiological evaluation of pre- and post-injury organ function should be considered when making a life expectancy calculation since a pre-existing reduction in organ system function may significantly reduce life expectancy.