Long-term functional health status of severely injured patients
Long-term functional health status of severely injured patients
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DOI：
10.1016/j.injury.2006.10.026
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发表时间：
2007-03-01
影响因子：
2.5
通讯作者：
Van der Werken, Chr.
中科院分区：
文献类型：
--
作者：
Holtslag, H. R.;Post, M. W.;Van der Werken, Chr.
背景：对重大创伤后果的研究传统上侧重于死亡率。本研究的目的是，首先，调查大量未选择的严重损伤患者的长期功能健康状况，并将其与规范数据进行比较；其次，探讨功能健康状况与个人和损伤特征之间的关系。方法：在荷兰乌得勒支大学医学中心（一级创伤中心）进行了一项前瞻性队列研究。从1999年1月至2000年12月，连续的重大创伤幸存者（ISS >= 16; > 16岁）被纳入研究。平均15个月（12-18个月）后，359名符合条件的人中有335人（反应率93%）参加了研究。从以医院为基础的登记系统中检索人口统计学和损伤特征。使用136项疾病影响概况（SIP）测量功能健康状态。在随访检查中使用26个标准条件清单评估合并症。结果：男性249例，女性86例，平均年龄37.7岁，平均ISS为24.9 （sd = 10.6）。近四分之三的人是交通事故受害者。平均住院时间为25天（s.d. = 23.4）。70%的受试者选择出院目的地是家。随访时，SIP平均总分为9.3分（sd = 10.1），为轻度至中度残疾。生理功能维度平均得分为7.2分（S.D. = 9.8），心理社会功能维度平均得分为8.7分（S.D. = 12.0）。大多数问题发生在工作、行走、家庭管理、娱乐和消遣以及警觉性行为方面。与老年患者相比，年轻受试者的分数与标准分数的偏差更大。损伤类型，特别是创伤性脑、脊髓损伤和肢体损伤，是1年后心理社会和身体功能的预测因子。然而，最重要的预测因素是年龄和合并症。(C) 2006 Elsevier Ltd版权所有。
Background: Studies of the consequences of major trauma have traditionally focused on mortality rates. The aims of this study were, firstly, to investigate the long-term functional health status in a large, unselected group of severely injured patients and to compare this with normative data, and secondly, to explore relations between functional health status and personal and injury characteristics. Methods: A prospective cohort study was performed at the University Medical Centre Utrecht (a level-1 trauma centre) in The Netherlands. Consecutive survivors of major trauma (ISS >= 16; > 16 years of age) were included from January 1999 until December 2000. After an average of 15 months (range 12-18 months), 335 of the 359 eligible persons (response rate 93%) participated. Demographic and injury characteristics were retrieved from a hospital-based registration system. Functional health status was measured using the 136-item Sickness impact profile (SIP). Co-morbidity was assessed at the follow-up examination using a standard list of 26 conditions. Results: Subjects were 249 men and 86 women, mean age 37.7 years, mean ISS was 24.9 (S.D. = 10.6). Almost, three quarters were traffic victims. Mean hospital stay was 25 days (S. D. = 23.4). Discharge destination was home in 70% of all subjects. At follow-up, the mean overall SIP score was 9.3 (S.D. = 10.1), which means mild to moderate disability. The mean score on the physical function dimension was 7.2 (S.D. = 9.8) and that on psychosocial function was 8.7 (S.D. = 12.0). Most problems were experienced in the categories of Work, Ambulation, Home Management, Recreation and Pastimes, and Alertness Behaviour. Scores of younger subjects deviated more strongly from the norm scores than those of elderly patients. Type of injury, especially lesions of traumatic brain and spinal cord and extremity injuries, was a predictor of both psychosocial and physical functioning after more than 1 year. The most important predictors, however, were age and co-morbidity. (C) 2006 Elsevier Ltd. All rights reserved.