Functional outcome and health status of injured patients with peripheral nerve lesions
Functional outcome and health status of injured patients with peripheral nerve lesions
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DOI：
10.1016/j.injury.2009.05.002
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发表时间：
2010-05-01
影响因子：
2.5
通讯作者：
Di Rienzo, Filomena
中科院分区：
文献类型：
--
作者：
Intiso, Domenico;Grimaldi, Giuseppina;Di Rienzo, Filomena
背景：周围神经损伤(PNL)可使多发损伤患者的临床过程和结果复杂化。由于这经常阻碍康复，这对患者和临床医生来说都是一个沉重的负担。本研究的目的是调查PNL患者的长期转归和健康状况。研究对象和方法：确定接受强化康复治疗的多发伤患者。所有患者在入院、出院和随访时均进行Barthel和改良Rankin量表(MRS)评定。结果：共纳入77例多发伤患者，其中45例(男22例，女23例；年龄19~83岁，平均59.7±21.7岁)。在受伤的患者中，22例(男性10例，女性12例)没有PNL，23例(男性12例，女性11例)没有PNL。PLN组入院、出院和随访时的Barthel评分分别为33.4±/-17.9、85.3+/-3.8和93.0+/-6.9(p<；0.001)，MRS评分中位数分别为4(四分位数范围：3~5)、3(IQR：1~3)和1(IQR：0~2)。非PLN组入院时、出院时和随访期的Barthel评分分别为30.4±14.5、86.6±-9.8和96.6±-4.9(p<；0.001)，MRS评分的中位数分别为4(智商比：3-5)、2(智商比：1-3)和0.5(智商比：0-2)。PNL组平均住院天数为86.7±10.8天，非PNL组为65.6±14.6天。两组间SF-36评分差异无统计学意义，但PNL组和PNL组各项目均分均显著低于全国人群常模。结论：多发伤合并PNL组和无PNL组患者康复后均有明显改善，远期预后良好。然而，那些患有PNL的患者比没有PNL的患者住院时间更长，需要更多的康复。两组患者的健康状况都有明显的困难。(C)2009爱思唯尔有限公司。保留所有权利。
Background: Peripheral nerve lesions (PNLs) can complicate the clinical course and outcome of multiply injured patients. Since this often impedes recovery, it can be a significant burden for both patients and clinicians. The objective of the present study was to investigate the long-term outcome and health status of patients with PNL.Subjects and methods: Multiply injured patients admitted to an intensive rehabilitation setting were identified. The Barthel and modified Rankin scales (mRS) were administered to all patients at admission, discharge and follow-up. The short form (SF)-36 questionnaire was used at follow-up (mean: 25.3 +/- 6.5 months).Results: Seventy-seven multiply injured patients were identified, and 45 (22 male, 23 female; mean age: 59.7 +/- 21.7 years; range: 19-83 years) were enrolled. Of the injured patients, 22 subjects (10 male and 12 female) had no PNL, while 23 (12 male, 11 female) did. In the PLN group, the mean Barthel scores at admission, discharge and follow-up, respectively, were 33.4 +/- 17.9, 85.3 +/- 3.8 and 93.0 +/- 6.9 (p < 0.001) and the median mRS scores were 4 (interquartile range (IQR): 3-5), 3 (IQR: 1-3) and 1 (IQR: 0-2), respectively. In the group without PLN, the mean Barthel scores at admission, discharge and follow-up, respectively, were 30.4 +/- 14.5, 86.6 +/- 9.8 and 96.6 +/- 4.9 (p < 0.001) and the median mRS scores were 4 (IQR: 3-5), 2 (IQR: 1-3) and 0.5 (IQR: 0-2). The mean length of hospital stay was 86.7 +/- 10.8 and 65.6 +/- 14.6 days in patients with and without PNL, respectively. The SF-36 did not show significant differences between the groups, but the patients with and without PNL reported significant lower mean scores on all items compared to national population norms.Conclusion: Multiply injured patients with and without PNL showed significant improvement and a good long-term outcome after rehabilitation. However, those with PNL had a longer hospital stay and needed more rehabilitation than patients without PNL. Both the groups of patients experienced significant difficulties in the health status. (C) 2009 Elsevier Ltd. All rights reserved.