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重症监护病房出院一年后多发伤幸存者的健康相关生活质量与残疾情况

Health-related quality of life and disability in survivors of multiple trauma one year after intensive care unit discharge.

作者信息

Dimopoulou Ioanna, Anthi Anastasia, Mastora Zafiria, Theodorakopoulou Maria, Konstandinidis Alexandros, Evangelou Evangelos, Mandragos Konstantinos, Roussos Charis

机构信息

Department of Critical Care Medicine, Evangelismos Hospital, Athens, Greece.

出版信息

Am J Phys Med Rehabil. 2004 Mar;83(3):171-6. doi: 10.1097/01.phm.0000107497.77487.c1.

Abstract

OBJECTIVE

To evaluate health-related quality of life and disability in multiple-trauma patients requiring intensive care unit management.

DESIGN

A total of 87 survivors of multiple trauma, with a median age of 31 yrs and a median Injury Severity Score of 22, were enrolled in the present study. The Nottingham Health Profile, Glasgow Outcome Scale, and Rosser Disability Scale were used to assess the functional consequences of trauma 1 yr after intensive care unit discharge.

RESULTS

A total of 64 of 87 patients had a problem in at least one of the six domains related to subjective health status. The most prevalent complaint was related to somatic subdimensions, but emotional functioning was also affected. Nottingham Health Profile part 2 showed that 63 of the survivors experienced problems in at least one of the daily activities. Of particular importance, inability to work was reported by 47% of the patients. Fifty-nine percent experienced moderate-to-severe disability as evaluated by Glasgow Outcome Scale and Rosser Disability Scale. High aggregate injury severity score along with severe head trauma were independent predictors of poor health-related quality of life and disability.

CONCLUSIONS

The majority of survivors of major trauma exhibit considerable levels of disability and impairment in health-related quality of life. Global injury severity score and degree of brain trauma determine functional limitations. This information may help in organizing long-term rehabilitation of multiple-trauma patients.

摘要

目的

评估需要重症监护病房管理的多发伤患者的健康相关生活质量和残疾情况。

设计

本研究共纳入87例多发伤幸存者,中位年龄31岁,中位损伤严重度评分为22分。采用诺丁汉健康量表、格拉斯哥预后量表和罗瑟残疾量表评估重症监护病房出院1年后创伤的功能后果。

结果

87例患者中共有64例在与主观健康状况相关的六个领域中至少有一个存在问题。最常见的主诉与躯体亚维度有关,但情绪功能也受到影响。诺丁汉健康量表第2部分显示,63例幸存者在至少一项日常活动中存在问题。特别重要的是,47%的患者报告无法工作。根据格拉斯哥预后量表和罗瑟残疾量表评估,59%的患者有中度至重度残疾。高累计损伤严重度评分以及严重颅脑外伤是健康相关生活质量差和残疾的独立预测因素。

结论

大多数严重创伤幸存者在健康相关生活质量方面存在相当程度的残疾和损害。总体损伤严重度评分和脑外伤程度决定功能限制。这些信息可能有助于组织多发伤患者的长期康复。

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