Graham Colin A, Gordon Malcolm W G, Roy Christopher W, Hanlon Philip W
Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR.
Eur J Emerg Med. 2007 Feb;14(1):35-8. doi: 10.1097/01.mej.0000224440.12612.62.
The aim of this study was to identify the outcomes of survivors of blunt major trauma (without head injury) 2 years or more following injury. The study uses a case-control design, is set in the West of Scotland and includes trauma patients treated in Greater Glasgow NHS Board hospitals. Participants consisted of patients who had sustained major trauma (injury severity score >15) with little or no head injury at least 2 years before assessment, identified from the Scottish Trauma Audit Group database, and age and sex-matched controls nominated by the index case's general practitioner. Nineteen cases and seven controls completed the study from 223 potential cases and 39 potential controls. Participants and non-participants had comparable injury severity score, probability of survival (Ps) and length of stay. American Medical Association impairment scores show survivors were more impaired than controls (25.9 vs 7.4%, P=0.043). No differences were observed in Functional Independence Measure (FIM) or Community Integration Questionnaire (CIQ) scores, although a type II error is possible. Short-form 36 (SF36) Physical Component Summary (PCS) scores of survivors showed no difference compared with controls although survivors' PCS scores were below UK and US means (P=0.008). SF36 Mental Component Summary (MCS) scores of survivors were below those of controls (45.07 vs 56.65, P=0.004) and normal values of the UK population (P=0.036). No differences in work status were noted, but small sample sizes were used. Non-head-injured survivors of major trauma in the West of Scotland have poorer health status (SF36), physically and mentally, than the UK population. They have greater impairment, but have an employment status comparable to that of the controls. The lack of differences in FIM and CIQ scores between survivors and controls may be due to small sample sizes.
本研究的目的是确定钝性严重创伤（无头部损伤）幸存者受伤两年或更长时间后的结局。该研究采用病例对照设计，在苏格兰西部进行，纳入了在大格拉斯哥国民保健服务委员会医院接受治疗的创伤患者。参与者包括在评估前至少两年遭受严重创伤（损伤严重程度评分>15）且头部损伤很少或没有头部损伤的患者，这些患者从苏格兰创伤审计组数据库中识别出来，以及由索引病例的全科医生提名的年龄和性别匹配的对照组。从223例潜在病例和39例潜在对照中，19例病例和7例对照完成了研究。参与者和非参与者的损伤严重程度评分、生存概率（Ps）和住院时间具有可比性。美国医学协会损伤评分显示，幸存者比对照组受损更严重（25.9%对7.4%，P=0.043）。尽管可能存在II类错误，但在功能独立性测量（FIM）或社区融合问卷（CIQ）评分中未观察到差异。幸存者的简明健康调查问卷36项（SF36）身体成分总结（PCS）评分与对照组相比无差异，尽管幸存者的PCS评分低于英国和美国的均值（P=0.008）。幸存者的SF36心理成分总结（MCS）评分低于对照组（45.07对56.65，P=0.004）和英国人群的正常值（P=0.036）。工作状态方面未发现差异，但样本量较小。苏格兰西部严重创伤的非头部受伤幸存者在身体和精神方面的健康状况（SF36）比英国人群差。他们有更大的损伤，但就业状况与对照组相当。幸存者与对照组在FIM和CIQ评分上缺乏差异可能是由于样本量较小。
