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术后骨盆环骨折患者的健康相关生活质量和生活满意度。一项前瞻性观察研究,随访两年。

Health-related quality of life and life satisfaction in patients following surgically treated pelvic ring fractures. A prospective observational study with two years follow-up.

机构信息

Department of Orthopaedic Surgery, Uppsala University Hospital, Uppsala, Sweden.

出版信息

Injury. 2010 Apr;41(4):400-4. doi: 10.1016/j.injury.2009.11.006. Epub 2009 Dec 14.

Abstract

BACKGROUND

Pelvic ring fractures caused by high-energy trauma are severe injuries with well described radiological and clinical outcomes, whereas description from the patient's perspective is less well documented. The purpose of this study was to investigate patient-reported outcome following surgical treatment of pelvic fractures using quality of life instruments.

METHODS

All 54 patients (28 male/26 female, ages 16-68) with pelvic fractures referred to our institution for surgical treatment 2003-2005 were prospectively included. The most common trauma was motor vehicle accident (44%). Additional injuries were seen in 74% and in 31% the ISS was >or=16. There were 31 B and 23 C type fractures. Patients were followed for two years using two validated questionnaires, SF-36 and LiSat-11, the latter an instrument consisting of 11 questions for evaluation of satisfaction with different aspects of life.

RESULTS

45 patients could be followed according to the study protocol for two years while 2 were untraceable and 1 died from unrelated causes. Of 6 nonresponders, 5 were unable due to psychiatric disorder. At two years pelvic fracture patients scored lower than the reference population in both physical and mental domains (SF-36). Highest mean score, 68, was in the domain Social Function (norm 89) while lowest mean score, 38, was in the domain Role Physical (norm 86). The mean score closest to the normative was for general health with 61 for patients and 78 for the normative group. In LiSat-11 pelvic fracture patients scored lower than the reference population in all areas. Satisfaction with life as a whole was 31% compared with 60% in the normative group.

CONCLUSIONS

Two years after surgical treatment of pelvic ring fractures, patients reported substantially lower quality of life for both physical and mental domains, when compared with a reference population, even when radiological and clinical outcomes were considered favourable.

摘要

背景

高能创伤导致的骨盆环骨折是一种严重的损伤,其影像学和临床结果已有很好的描述,而患者角度的描述则记录较少。本研究旨在使用生活质量工具调查骨盆骨折患者手术后的患者报告结局。

方法

2003-2005 年,我们机构对 54 例(28 名男性/26 名女性,年龄 16-68 岁)骨盆骨折患者进行了前瞻性研究。最常见的创伤是机动车事故(44%)。74%的患者有其他损伤,31%的患者 ISS 大于等于 16。有 31 例 B 型和 23 例 C 型骨折。使用两种经过验证的问卷(SF-36 和 LiSat-11)对患者进行了两年的随访,后者是由 11 个问题组成的仪器,用于评估对生活不同方面的满意度。

结果

45 例患者可按照研究方案随访两年,2 例患者无法追踪,1 例患者死于无关原因。在 6 例未应答者中,有 5 例由于精神障碍而无法应答。在两年时,骨盆骨折患者在身体和心理领域的评分均低于参考人群(SF-36)。最高的平均得分(68)出现在社会功能领域(正常 89),而最低的平均得分(38)出现在身体角色领域(正常 86)。最接近正常值的平均得分为一般健康状况,患者为 61,正常组为 78。在 LiSat-11 中,骨盆骨折患者在所有领域的评分均低于参考人群。对生活整体的满意度为 31%,而正常组为 60%。

结论

即使考虑到影像学和临床结果良好,与参考人群相比,骨盆环骨折患者手术后两年的身体和心理领域的生活质量明显较低。

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