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Trauma systems have improved short-term survival of the severely injured but knowledge on long-term outcome is limited. This study aimed to assess outcome 6 years to 9 years after moderate to severe injury in terms of survival, Health-Related Quality of Life (HRQOL) and employment status.Patients admitted to Aarhus Level I Trauma Center in 1998 to 2000, aged 15 years or more, with an Injury Severity Score (ISS) ≥9 were included. Patients were divided into three groups based on ISS (ISS, 9–15; ISS, 16–24; ISS >24). Survival status was obtained from the Danish Central Person Registry. HRQOL was measured with the Short Form 36 (SF-36) questionnaire, which was mailed to survivors 6 years to 9 years after admission and compared with a matched control group.Three hundred twenty-two patients were included. Seventy-one percentage were men, median age was 34 years (range, 15–89 years), median ISS was 17 (range, 9–75). In-hospital survival was 85%. After a median of 7.3 years, overall survival was 78%. After hospital discharge, no difference in survival was found between the three patient groups.Sixty-nine percentage of the contacted patients completed the SF-36. Mean SF-36 scores were significantly lower in the patient group than in the control group in all eight SF-36 domains (p < 0.001). Return to employment or education was 52%, whereas 20% of the patients reported to be on early retirement.Six years to nine years after traumatic injury, 78% of the patients were alive. HRQOL was significantly lower for injured patients than a matched control group. Twenty percentage of the patients retired early.