University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
Qual Life Res. 2019 Oct;28(10):2731-2739. doi: 10.1007/s11136-019-02211-y. Epub 2019 May 16.
Routine collection of post-discharge patient-reported outcomes within trauma registries can be used to benchmark quality of trauma care. This process is dependent on geographic and cultural context, but results are lacking regarding the European experience. We aimed to investigate the feasibility of routine inclusion of longer-term patient-reported health-related quality of life (HRQoL) in a Dutch National Trauma Database (DNTD) and to characterize these outcomes in a prospective cohort study.
All adult patients (≥ 18 years) who presented for traumatic injury in 2015-2016 and met the inclusion criteria of the DNTD were included. Inclusion criteria of the DNTD are presence of traumatic injury, hospital presentation within 48 h from trauma and hospital admission for treatment of traumatic injury or immediate mortality from traumatic injury after presentation. Exclusion criteria were death, mental impairment, insufficient command of Dutch language and residency outside the Netherlands. Primary outcomes were process-related measures of feasibility (response rate, response methods and reasons for non-response). Secondary outcomes were HRQoL measures [EuroQOL 5-Dimensions 3-Level (EQ-5D-3L) with added cognitive dimension and Visual Analogue Scale (EQ-VAS)].
2025 unique patients met the initial inclusion criteria, with 1753 patients eligible for follow-up. Of these, 1315 patients participated (response rate 75%). The majority of questionnaires, 990 (75%), were completed on paper, with an additional 325 (25%) through telephone interviews. Primary reason for non-response was lack of contact information (245/438 non-responders; 56%). Median EQ-5D score was 0.81 (IQR 0.68-1.00) (mean 0.74; SD 0.31) and median EQ-VAS score was 78 (IQR 65-90). Compared to a Dutch reference population (mean EQ-5D = 0.87), EQ-5D scores were significantly lower (p < 0.001).
Routine collection of HRQoL is feasible within European health systems, like in the Netherlands. Further integration of these measures into trauma registries may aid worldwide benchmarking of trauma care quality.
在创伤登记处常规收集出院后患者报告的结局，可用于评估创伤护理质量。该过程取决于地理和文化背景，但欧洲的相关研究结果尚缺乏。我们旨在调查在荷兰国家创伤数据库（DNTD）中常规纳入长期患者报告的健康相关生活质量（HRQoL）的可行性，并在一项前瞻性队列研究中对这些结局进行特征描述。
纳入 2015-2016 年因创伤就诊且符合 DNTD 纳入标准的所有成年患者（≥18 岁）。DNTD 的纳入标准为存在创伤、创伤后 48 小时内就诊、因创伤住院治疗或创伤后就诊时即刻因创伤死亡。排除标准为死亡、精神障碍、荷兰语能力不足和居住在荷兰境外。主要结局为与可行性相关的过程指标（应答率、应答方法和无应答原因）。次要结局为 HRQoL 指标[欧洲五维健康量表 3 级（EQ-5D-3L）附加认知维度和视觉模拟量表（EQ-VAS）]。
2025 例患者符合初始纳入标准，其中 1753 例患者符合随访纳入标准。在这些患者中，有 1315 例（应答率 75%）参与研究。990 份（75%）问卷通过纸质形式完成，325 份（25%）通过电话访谈完成。无应答的主要原因为缺乏联系信息（245/438 例无应答者；56%）。EQ-5D 得分中位数为 0.81（四分位距 0.68-1.00）（均值 0.74；标准差 0.31），EQ-VAS 得分中位数为 78（四分位距 65-90）。与荷兰参考人群（EQ-5D 均值 0.87）相比，EQ-5D 得分显著较低（p<0.001）。
在欧洲卫生系统中，如荷兰，常规收集 HRQoL 是可行的。进一步将这些措施纳入创伤登记处，可能有助于全球范围内对创伤护理质量进行基准比较。
