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Assessment of quality of life and functional outcome in patients sustaining moderate and major trauma: a multicentre, prospective cohort study.

AbstractBACKGROUND:
Trauma care systems aim to reduce both death and disability, yet there is little data on post-trauma health status and functional outcome.
OBJECTIVES:
To evaluate baseline, discharge, six month and 12 month post-trauma quality of life, functional outcome and predictors of quality of life in Hong Kong.
METHODS:
Multicentre, prospective cohort study using data from the trauma registries of three regional trauma centres in Hong Kong. Trauma patients with an ISS≥9 and aged≥18 years were included. The main outcome measures were the physical component summary (PCS) score and mental component summary (MCS) scores of the Short-Form 36 (SF36) for health status, and the extended Glasgow Outcome Scale (GOSE) for functional outcome.
RESULTS:
Between 1 January 2010 and 31 September 2010, 400 patients (mean age 53.3 years; range 18-106; 69.5% male) were recruited to the study. There were no statistically significant differences in baseline characteristics between responders (N=177) and surviving non-responders (N=163). However, there were significant differences between these groups and the group of patients who died (N=60). Only 16/400 (4%) cases reported a GOSE≥7. 62/400 (15.5%) responders reached the HK population norm for PCS. 125/400 (31%) responders reached the HK population norm for MCS. If non-responders had similar outcomes to responders, then the percentages for GOSE≥7 would rise from 4% to 8%, for PCS from 15.5% to 30%, and for MCS from 31% to 60%. Univariate analysis showed that 12-month poor quality of life was significantly associated with age>65 years (OR 4.77), male gender (OR 0.44), pre-injury health problems (OR 2.30), admission to ICU (OR 2.15), ISS score 26-40 (OR 3.72), baseline PCS (OR 0.89), one-month PCS (OR 0.89), one-month MCS (OR 0.97), 6-month PCS (OR 0.76) and 6-month MCS (OR 0.97).
CONCLUSION:
For patients sustaining moderate or major trauma in Hong Kong at 12 months after injury<1 in 10 patients had an excellent recovery, ≤3 in 10 reached a physical health status score≥Hong Kong norm, although as many as 6 in 10 patients had a mental health status score which is≥Hong Kong norm.
AuthorsT H Rainer, J H H Yeung, S K C Cheung, Y K Y Yuen, W S Poon, H F Ho, C W Kam, G N Cattermole, A Chang, F L So, C A Graham
JournalInjury (Injury) Vol. 45 Issue 5 Pg. 902-9 (May 2014) ISSN: 1879-0267 [Electronic] Netherlands
PMID24314871 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2013 Elsevier Ltd. All rights reserved.
Topics
  • Activities of Daily Living (psychology)
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Disabled Persons (psychology, statistics & numerical data)
  • Female
  • Follow-Up Studies
  • Glasgow Outcome Scale
  • Hong Kong (epidemiology)
  • Humans
  • Injury Severity Score
  • Length of Stay (statistics & numerical data)
  • Male
  • Middle Aged
  • Multiple Trauma (epidemiology, physiopathology, psychology)
  • Patient Discharge (statistics & numerical data)
  • Prospective Studies
  • Quality of Life
  • Recovery of Function
  • Social Support
  • Stress Disorders, Post-Traumatic (epidemiology, etiology, psychology)
  • Treatment Outcome
  • Wounds and Injuries (epidemiology, physiopathology, psychology)

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