Posttraumatic stress symptoms and health-related quality of life: a two year follow up study of injury treated at the emergency department.
Posttraumatic stress symptoms and health-related quality of life: a two year follow up study of injury treated at the emergency department.
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DOI：
10.1186/1471-244x-12-1
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发表时间：
2012-01-09
期刊：
影响因子：
4.4
通讯作者：
van Beeck EF
中科院分区：
文献类型：
--
作者：
Haagsma JA;Polinder S;Olff M;Toet H;Bonsel GJ;van Beeck EF
创伤后应激障碍（PTSD）是创伤后应激障碍（PTSD）的一种常见表现，与功能障碍和健康相关生活质量（HRQoL）下降有关。以前针对后者的研究仅限于严重程度较高的损伤。本研究在所有严重程度和外部原因的损伤患者的综合人群中检查PTSD症状和健康相关生活质量（HRQoL）之间的关联。我们进行了一项自我评估调查，其中包括患者的人口统计学，事故类型，持续伤害，EuroQol健康分类系统（EQ-5D）和健康效用指数（HUI）测量功能结局和HRQoL，以及事件影响量表（IES）测量PTSD症状。IES 35分或更高被用作PTSD存在的指示。这项调查是由1,781名受伤患者在急诊科（艾德）接受治疗两年后完成的，随后要么住院，要么直接出院到家庭环境。在住院（0.23-0.24）和非住院（0.32-0.33）患者中，提示PTSD的症状与功能结局的所有EQ-5D和HUI 3领域的更多问题以及相当大的效用损失相关。IES评分高于或低于35的患者之间报告的问题差异最大的是EQ-5D健康领域疼痛/不适（82%与28%）和焦虑/抑郁（53%与11%）以及HUI情绪领域（92%与33%）和疼痛（84%与38%）。在调整潜在的混杂因素后，PTSD仍然与不良HRQoL密切相关。在接受艾德治疗的患者中，创伤后应激障碍的创伤后应激症状与住院和非住院患者的HRQoL显著下降相关。因此，PTSD症状可能会对即使是轻微严重程度的损伤患者的完全恢复造成重大障碍。
Among injury victims relatively high prevalence rates of posttraumatic stress disorder (PTSD) have been found. PTSD is associated with functional impairments and decreased health-related quality of life (HRQoL). Previous studies that addressed the latter were restricted to injuries at the higher end of the severity spectrum. This study examined the association between PTSD symptoms and health-related quality of life (HRQoL) in a comprehensive population of injury patients of all severity levels and external causes. We conducted a self-assessment survey which included items regarding demographics of the patient, accident type, sustained injuries, EuroQol health classification system (EQ-5D) and Health Utilities Index (HUI) to measure functional outcome and HRQoL, and the Impact of Event Scale (IES) to measure PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of PTSD. The survey was completed by 1,781 injury patients two years after they were treated at the Emergency Department (ED), followed by either hospital admission or direct discharge to the home environment. Symptoms indicative of PTSD were associated with more problems on all EQ-5D and HUI3 domains of functional outcome and a considerable utility loss in both hospitalized (0.23-0.24) and non-hospitalized (0.32-0.33) patients. Differences in reported problems between patients with IES scores higher or lower than 35 were largest for EQ-5D health domains pain/discomfort (82% versus 28%) and anxiety/depression (53% versus 11%) and HUI domains emotion (92% versus 33%) and pain (84% versus 38%). After adjusting for potential confounders, PTSD remained strongly associated with adverse HRQoL. Among patients treated at an ED posttraumatic stress symptoms indicative of PTSD were associated with a considerable decrease in HRQoL in both hospitalized and non-hospitalized patients. PTSD symptoms may therefore raise a major barrier for full recovery of injury patients of even minor levels of severity.