Simmel S, Drisch S, Haag S, Bühren V
Chirurg. 2013 Sep;84(9):771-9. doi: 10.1007/s00104-013-2479-y.
The survival chances of multiple trauma patients have continually improved over the last decades; therefore, it is often not a question of whether a patient survives a severe accident but rather how the patient survives.
In a retrospective study 127 patients were questioned regarding quality of life and health and possible influencing factors using the POLO chart an average of 70 months after suffering severe trauma (ISS Ø 35.6).
The quality of life of severely injured patients is significantly reduced compared with the normal population even years after the trauma. In addition to four pretraumatic factors (older age, female gender, low education and previous illnesses) four posttraumatic variables (difficulties with authorities/institutions and unemployment as a consequence of the accident, long duration and subjectively inadequate treatment in hospital) were identified that have a negative impact on long-term quality of life.
The self-reported quality of life after multiple trauma no longer permanently achieves the original level despite extensive rehabilitation measures. Post-traumatic factors have a greater impact on the long-term quality of life than the injury severity. A long-term care and specialized rehabilitation services are needed to improve outcome further.
在过去几十年中,多发伤患者的生存几率持续提高;因此,问题往往不在于患者能否从严重事故中存活下来,而在于患者如何存活下来。
在一项回顾性研究中,对127例患者在遭受严重创伤(损伤严重度评分平均为35.6)平均70个月后,使用POLO图表询问其生活质量、健康状况及可能的影响因素。
即使在创伤多年后,重伤患者的生活质量与正常人群相比仍显著降低。除了四个创伤前因素(年龄较大、女性、低学历和既往疾病)外,还确定了四个创伤后变量(因事故导致与当局/机构打交道困难和失业、住院时间长以及主观上认为治疗不充分),这些因素对长期生活质量有负面影响。
尽管采取了广泛的康复措施,多发伤后自我报告的生活质量仍无法永久恢复到原来的水平。创伤后因素对长期生活质量的影响大于损伤严重程度。需要长期护理和专业康复服务以进一步改善预后。