Kruithof N, de Jongh M A C, de Munter L, Lansink K W W, Polinder S
Elisabeth-TweeSteden Hospital, Department Trauma TopCare, Tilburg, the Netherlands.
Elisabeth-TweeSteden Hospital, Department Trauma TopCare, Tilburg, the Netherlands; Brabant Trauma Registry, Network Emergency Care Brabant, the Netherlands.
Injury. 2017 Mar;48(3):578-590. doi: 10.1016/j.injury.2017.01.013. Epub 2017 Jan 5.
Over the past decades, the number of survivors of injuries has rapidly grown. It has become important to focus more on the determinants of non-fatal outcome. Although socio-economic status (SES) is considered to be a fundamental determinant of health in general, the role of SES as a determinant of non-fatal outcome after injury is largely unknown.
An online search was conducted in November 2015 using Embase, Medline, Web of Science, Cinahl, Cochrane, Google scholar and PubMed. Studies examining the relation between SES and a physical or psychological outcome measure, or using SES as a confounder in a general trauma population were included. There were no restrictions regarding study design. The 'Quality in Prognostic Studies tool' was used to assess the methodological quality of the included studies.
The 24 included studies showed large variations in methodological quality. The number of participants ranged from 56 to 4639, and assessments of the measures ranged from immediately to 6year post-injury. Studies used a large number of variables as indicators of SES. Participant's educational level was used most frequently. The majority of the studies used a multivariable technique to analyse the relation between SES and non-fatal outcome after injury. All studies found a positive association (80% of studies significant, n=19) between increased SES and better non-fatal outcome after injury.
Although an adequate and valid measure of SES is lacking, the results of this review showed that SES is an important determinant of non-fatal outcome after injury. Future research should focus on the definition and measurement of SES and should further underpin the effect of SES on non-fatal outcome after injury.
在过去几十年中，受伤幸存者的数量迅速增长。更加关注非致命结局的决定因素变得很重要。虽然社会经济地位（SES）一般被认为是健康的一个基本决定因素，但SES作为受伤后非致命结局的决定因素的作用在很大程度上尚不清楚。
2015年11月使用Embase、Medline、Web of Science、Cinahl、Cochrane、谷歌学术和PubMed进行了在线搜索。纳入了研究SES与身体或心理结局指标之间关系的研究，或在一般创伤人群中将SES用作混杂因素的研究。对研究设计没有限制。使用“预后研究质量工具”评估纳入研究的方法学质量。
纳入的24项研究在方法学质量上有很大差异。参与者数量从56到4639不等，对指标的评估从受伤后立即到6年。研究使用了大量变量作为SES的指标。参与者的教育水平使用最为频繁。大多数研究使用多变量技术分析SES与受伤后非致命结局之间的关系。所有研究都发现SES升高与受伤后更好的非致命结局之间存在正相关（80%的研究具有显著性，n = 19）。
虽然缺乏对SES的充分且有效的测量，但本综述结果表明SES是受伤后非致命结局的一个重要决定因素。未来的研究应侧重于SES的定义和测量，并应进一步证实SES对受伤后非致命结局的影响。
