Rainer T H, Yeung J H H, Cheung S K C, Yuen Y K Y, Poon W S, Ho H F, Kam C W, Cattermole G N, Chang A, So F L, Graham C A
Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong.
Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong.
Injury. 2014 May;45(5):902-9. doi: 10.1016/j.injury.2013.11.006. Epub 2013 Nov 21.
Trauma care systems aim to reduce both death and disability, yet there is little data on post-trauma health status and functional outcome.
To evaluate baseline, discharge, six month and 12 month post-trauma quality of life, functional outcome and predictors of quality of life in Hong Kong.
Multicentre, prospective cohort study using data from the trauma registries of three regional trauma centres in Hong Kong. Trauma patients with an ISS≥9 and aged≥18 years were included. The main outcome measures were the physical component summary (PCS) score and mental component summary (MCS) scores of the Short-Form 36 (SF36) for health status, and the extended Glasgow Outcome Scale (GOSE) for functional outcome.
Between 1 January 2010 and 31 September 2010, 400 patients (mean age 53.3 years; range 18-106; 69.5% male) were recruited to the study. There were no statistically significant differences in baseline characteristics between responders (N=177) and surviving non-responders (N=163). However, there were significant differences between these groups and the group of patients who died (N=60). Only 16/400 (4%) cases reported a GOSE≥7. 62/400 (15.5%) responders reached the HK population norm for PCS. 125/400 (31%) responders reached the HK population norm for MCS. If non-responders had similar outcomes to responders, then the percentages for GOSE≥7 would rise from 4% to 8%, for PCS from 15.5% to 30%, and for MCS from 31% to 60%. Univariate analysis showed that 12-month poor quality of life was significantly associated with age>65 years (OR 4.77), male gender (OR 0.44), pre-injury health problems (OR 2.30), admission to ICU (OR 2.15), ISS score 26-40 (OR 3.72), baseline PCS (OR 0.89), one-month PCS (OR 0.89), one-month MCS (OR 0.97), 6-month PCS (OR 0.76) and 6-month MCS (OR 0.97).
For patients sustaining moderate or major trauma in Hong Kong at 12 months after injury<1 in 10 patients had an excellent recovery, ≤3 in 10 reached a physical health status score≥Hong Kong norm, although as many as 6 in 10 patients had a mental health status score which is≥Hong Kong norm.
创伤护理系统旨在降低死亡率和残疾率，但关于创伤后健康状况和功能结局的数据很少。
评估香港创伤患者创伤后基线、出院时、6个月和12个月的生活质量、功能结局及生活质量的预测因素。
采用香港三个区域创伤中心创伤登记处的数据进行多中心前瞻性队列研究。纳入损伤严重度评分（ISS）≥9分且年龄≥18岁的创伤患者。主要结局指标包括健康状况的简明健康状况调查量表（SF-36）的生理健康评分（PCS）和心理健康评分（MCS），以及功能结局的扩展格拉斯哥结局量表（GOSE）。
2010年1月1日至2010年9月31日，400例患者（平均年龄53.3岁；范围18 - 106岁；69.5%为男性）被纳入研究。应答者（n = 177）和存活的无应答者（n = 163）之间的基线特征无统计学显著差异。然而，这些组与死亡患者组（n = 60）之间存在显著差异。仅16/400（4%）例报告GOSE≥7分。62/400（15.5%）应答者达到香港人群PCS评分标准。125/400（31%）应答者达到香港人群MCS评分标准。如果无应答者与应答者结局相似，那么GOSE≥7分的比例将从4%升至8%，PCS评分标准的比例从15.5%升至30%，MCS评分标准的比例从31%升至60%。单因素分析显示，12个月生活质量差与年龄>65岁（比值比[OR]4.77）、男性（OR 0.44）、伤前健康问题（OR 2.30）、入住重症监护病房（ICU）（OR 2.15）、ISS评分26 - 40（OR 3.72）、基线PCS（OR 0.89）、1个月PCS（OR 0.89）、1个月MCS（OR 0.97）、6个月PCS（OR 0.76）和6个月MCS（OR 0.97）显著相关。
在香港，对于中度或重度创伤患者，伤后12个月时，每10例患者中不到1例恢复良好，每10例中≤3例达到身体健康状况评分≥香港标准，尽管每10例中有多达6例患者的心理健康状况评分≥香港标准。
