ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department Trauma TopCare, Tilburg, the Netherlands.
Erasmus MC University Medical Centre, Department of Public Health, Rotterdam, the Netherlands; Erasmus MC University Medical Centre, Department of Emergency Medicine, Rotterdam, the Netherlands.
Injury. 2019 Apr;50(4):890-897. doi: 10.1016/j.injury.2019.03.039. Epub 2019 Mar 28.
Significant differences exist between retrospectively collected pre-injury Health Status (HS) of trauma patients and the HS of the general population. Compared to the general population, the trauma population includes a larger proportion of individuals with a low level of socio-economic status. The aim was to compare retrospectively collected pre-injury HS with HS of a sample of Dutch individuals not only adjusted for age and gender, but also for educational level.
Within three months post-trauma, pre-injury HS (n = 2987) was collected by using the EuroQol-five-dimension-3-level (EQ-5D-3L) questionnaire. Data were abstracted from the Brabant Injury Outcome Surveillance. The reference cohort (n = 1839) included a sample of the Dutch general population. Multiple regression was used to compare HS of both cohorts.
A higher recalled pre-injury EQ-5D-3L score of the injury cohort was reported compared to the HS of the reference cohort after adjustment for age (β = 0.014 [95% CI: 0.001,0.027] for males and β = 0.018 [95% CI: -0.001, 0.036] for females). After adjustment for age and educational level, the Beta showed a ≥10% increasement: males; unadjusted β = 0.006 [95% CI: -0.007, 0.019] to β = 0.014 [95% CI: 0.001, 0.027] after age adjustment to β = 0.020 [95% CI: 0.007, 0.033] after adjustment for age and educational level, females; unadjusted β = -0.018 [95% CI: -0.035, -0.001] to β = 0.018 [95% CI: -0.001, 0.036] after age adjustments to β = 0.025 [95% CI: 0.007, 0.043] after adjustments for age and educational level. After adjustment for age, gender and educational level, the injury cohort reported prior to the trauma less problems on the 'pain/discomfort' (OR = 0.522 [95% CI: 0.454, 0.602]) and the 'anxiety/depression' (OR = 0.745 [95% CI: 0.619, 0.897]) dimensions, as compared to the reference cohort. In contrast, the injury cohort reported significantly more problems on the 'self-care' dimension (OR = 1.497 [95% CI: 0.1.112, 2.016]) prior to the trauma.
Injured patients report better recalled pre-injury HS compared to the HS of the reference cohort. After adjustment for educational level, the difference in HS between the injury cohort and the reference cohort increases, underlining that other confounders might also influence HS.
创伤患者回顾性收集的受伤前健康状况（HS）与一般人群的 HS 存在显著差异。与一般人群相比，创伤人群中社会经济地位较低的个体比例更大。目的是比较创伤患者回顾性收集的受伤前 HS，不仅要调整年龄和性别，还要调整教育水平。
在创伤后三个月内，使用 EuroQol-五维-3 级（EQ-5D-3L）问卷收集受伤前 HS（n=2987）。数据从 Brabant 伤害结果监测中提取。参考队列（n=1839）包括荷兰一般人群的样本。使用多元回归比较两个队列的 HS。
与参考队列相比，调整年龄后，损伤队列报告的受伤前 EQ-5D-3L 评分更高（男性β=0.014[95%CI：0.001，0.027]，女性β=0.018[95%CI：-0.001，0.036]）。调整年龄和教育水平后，β值增加了≥10%：男性；未调整β=0.006[95%CI：-0.007，0.019]至β=0.014[95%CI：0.001，0.027]，年龄调整后β=0.020[95%CI：0.007，0.033]，调整年龄和教育水平后β=0.025[95%CI：0.007，0.043]，女性；未调整β=-0.018[95%CI：-0.035，-0.001]至β=0.018[95%CI：-0.001，0.036]，年龄调整后β=0.025[95%CI：0.007，0.043]，调整年龄和教育水平后β=0.025[95%CI：0.007，0.043]。调整年龄、性别和教育水平后，与参考队列相比，损伤队列报告在受伤前疼痛/不适（OR=0.522[95%CI：0.454，0.602]）和焦虑/抑郁（OR=0.745[95%CI：0.619，0.897]）维度上的问题更少。相比之下，在受伤前，损伤队列报告在自我护理维度上的问题明显更多（OR=1.497[95%CI：0.1.112，2.016]）。
受伤患者报告的受伤前 HS 比参考队列的 HS 更好。调整教育水平后，损伤队列和参考队列之间的 HS 差异增加，这表明其他混杂因素也可能影响 HS。
