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一项关于损伤后短期功能结局的队列研究:损伤前社会人口学和健康特征、损伤及与损伤相关的医疗保健的作用。

A cohort study of short-term functional outcomes following injury: the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare.

机构信息

Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, 55 Hanover St, Dunedin 9054, New Zealand.

出版信息

Health Qual Life Outcomes. 2011 Aug 18;9:68. doi: 10.1186/1477-7525-9-68.

Abstract

BACKGROUND

Injury outcome studies have tended to collect limited pre-injury characteristics, focus on a narrow range of injury types, predictors and outcomes, and be restricted to high threat to life injuries. We sought to identify the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare in determining short-term functional outcomes for a wide range of injuries.

METHODS

Study participants (aged 18-64 years inclusive) were those in the Prospective Outcomes of Injury Study, a cohort of 2856 persons who were injured and registered with New Zealand's national no-fault injury insurance agency. All information used in this paper was obtained directly from the participants, primarily by telephone interviews, approximately three months after their injury. The functional outcomes of interest were the five dimensions of the EQ-5D plus a cognitive dimension. We initially examined bivariate relationships between our independent measures and the dependent measures. Our multivariate analyses included adjustment for pre-injury EQ-5D status and time between injury and when information was obtained from participants.

RESULTS

Substantial portions of participants continued to have adverse outcomes approximately three months after their injury. Key pervasive factors predicting adverse outcomes were: being female, prior chronic illness, injuries to multiple body regions, being hospitalized for injury, self-perceived threat to life, and difficulty accessing health services.

CONCLUSION

Future injury outcome studies should include participants whose injuries are considered 'minor', as judged by acute health service utilization, and also consider a wider range of potential predictors of adverse outcomes.

摘要

背景

既往的损伤结局研究往往仅收集有限的损伤前特征,关注于狭窄范围的损伤类型、预测因素和结局,且仅局限于对生命有高威胁的损伤。我们旨在确定损伤前社会人口学和健康特征、损伤和与损伤相关的医疗保健在多大程度上决定了广泛损伤类型的短期功能结局。

方法

研究参与者(年龄 18-64 岁,含边界值)为新西兰无过错损伤保险机构登记的前瞻性损伤结局研究队列中的 2856 名损伤者。本文中使用的所有信息均直接从参与者处获得,主要通过电话访谈,在损伤后大约 3 个月时进行。感兴趣的功能结局是 EQ-5D 的五个维度加上认知维度。我们最初检查了独立测量指标与依赖测量指标之间的双变量关系。我们的多变量分析包括调整损伤前 EQ-5D 状态和损伤与从参与者处获得信息之间的时间。

结果

约在损伤后 3 个月时,大量参与者仍存在不良结局。预测不良结局的关键普遍因素是:女性、既往慢性疾病、多个身体部位损伤、因损伤住院、自我感知的生命威胁以及获取医疗服务的困难。

结论

未来的损伤结局研究应包括被急性卫生服务利用判定为“轻微”的损伤参与者,并且还应考虑更广泛的不良结局的潜在预测因素。

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