Health-Related Quality of Life and Unmet Healthcare Needs in the First Year Following Moderate-to-Severe Traumatic Injuries—An Observational Study

<b>Background:</b> Traumatic injuries often lead to long-lasting impairments and complex rehabilitation needs. Trauma patients report lower health-related quality of life (HRQoL) and increased needs for healthcare and social support. This study aimed to describe HRQoL trajectories in a Norwegian cohort with moderate-to-severe trauma over 12 months and assess the relationship between unmet needs and HRQoL. <b>Methods:</b> A multicenter prospective cohort study with follow-up at six and twelve months post-injury included adults aged 18+ with a New Injury Severity Score (NISS) > 9 and a minimum hospital stay of two days. HRQoL was assessed using the EQ-5D-5L. Needs and unmet needs were evaluated using the Needs and Provision Complexity Scale. Hierarchical linear modeling (HLM) examined predictors of HRQoL trajectories. <b>Results:</b> Of 538 participants, 83% were followed up at six and/or twelve months. Mean age was 52 years, falls were the most common cause of injury (44%), and 76% had a severe injury (NISS > 15). HRQoL remained stable, except for improvements in usual activities and anxiety-depression domains. HLM showed that older age (<i>b</i> = -2.698), longer hospital stay (<i>b</i> = -4.108), and unmet healthcare (<i>b</i> = -1.094) and social support needs (<i>b</i> = -3.132) were associated with worse HRQoL over time. Unmet personal care needs were linked to improved HRQoL (<i>b</i> = 2.654). The only significant predictor*time interaction was between unmet healthcare needs and overall HRQoL. <b>Conclusions:</b> HRQoL largely remained stable, with improvements in some domains. Unmet healthcare needs predicted a decline in HRQoL, highlighting the importance of timely support and targeted interventions from health professionals.