Black James A, Herbison G Peter, Lyons Ronan A, Polinder Suzanne, Derrett Sarah
Injury Prevention Research Unit (IPRU), Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand.
J Trauma. 2011 Oct;71(4):1003-10. doi: 10.1097/TA.0b013e3182238833.
General information of health-related quality of life pathways to recovery after injury are largely absent from the literature. This article describes a study which: (1) collated and synthesized individual patient data of injured persons from an earlier systematic review and (2) produced general predictions of health-related quality of life for different injury groups for up to 1 year postinjury.
A systematic search of literature from January 1990 to December 2008 was completed. Researchers were approached to share their anonymous individual level data. Injuries were grouped into 39 categories based on the Eurocost injury classifications. Multilevel mixed effects models were used to produce predictions across both the five dimensions and the visual analog scale of the EQ-5D measure at 3 days, 30 days, 120 days, and 360 days postinjury.
Individual patient data from 10,496 injured persons (76% of known data worldwide) was retrieved. Predictions were fitted to 27 of the 39 injury categories covering a wide spectrum of injury types. Across most injuries, pain, or discomfort, usual activities and mobility were the most commonly impaired dimensions. Recovery for pain or discomfort was generally more gradual than other health dimensions. For many injury categories, a considerable proportion of people reported residual impairment at 360 days. Regardless of the anatomic location of injury, similar patterns of recovery or persistent impairment were seen for fractures and strains/sprains. Recovery patterns differed and took much longer than estimated in the Global Burden of Disease Study.
This study has produced recovery patterns for 27 injury groups using most of the worldwide individual-level data. For many injury categories, recovery is incomplete and takes much longer than estimated. This study infers that the burden of injury is likely being underestimated.
关于受伤后恢复的健康相关生活质量途径的一般信息在文献中基本缺失。本文描述了一项研究，该研究：（1）整理并综合了早期系统评价中受伤者的个体患者数据；（2）对受伤后长达1年的不同受伤群体的健康相关生活质量进行了一般预测。
完成了对1990年1月至2008年12月文献的系统检索。研究人员被要求分享他们的匿名个体层面数据。根据欧洲成本伤害分类，伤害被分为39类。使用多水平混合效应模型在受伤后3天、30天、120天和360天对EQ-5D测量的五个维度和视觉模拟量表进行预测。
检索到了来自10496名受伤者的个体患者数据（占全球已知数据的76%）。预测适用于39种伤害类别中的27种，涵盖了广泛的伤害类型。在大多数伤害中，疼痛或不适、日常活动和行动能力是最常受损的维度。疼痛或不适的恢复通常比其他健康维度更缓慢。对于许多伤害类别，相当一部分人在360天时报告有残留损伤。无论伤害的解剖位置如何，骨折和拉伤/扭伤的恢复模式或持续损伤相似。恢复模式不同，且比《全球疾病负担研究》估计的时间长得多。
本研究使用了全球大部分个体层面数据得出了27个受伤群体的恢复模式。对于许多伤害类别，恢复是不完全的，且所需时间比估计的长得多。本研究推断伤害负担可能被低估了。
