Mundy Lily R, Grier A Jordan, Weissler E Hope, Carty Matthew J, Pusic Andrea L, Hollenbeck Scott T, Gage Mark J
Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University, Durham, N.C.
Department of Orthopaedic Surgery, Section of Orthopaedic Trauma, Duke University, Durham, N.C.
Plast Reconstr Surg Glob Open. 2019 May 3;7(5):e2218. doi: 10.1097/GOX.0000000000002218. eCollection 2019 May.
Advances in fracture fixation and soft tissue coverage continue to improve the care of patients after limb-threatening lower extremity (LE) trauma. However, debate continues regarding which treatment option-reconstruction or amputation-is most appropriate. Many authors have attempted to quantify the patient experience in this treatment paradigm; however, they have not used patient-reported outcome (PRO) instruments specific to this population. Our aim was to identify and evaluate PRO instruments developed specifically for LE trauma, applicable to reconstruction and amputation, using established PRO instrument development and validation guidelines.
A multidisciplinary team used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method to query PubMed, Medline Ovid, EMBASE, Cochrane, Medline Web of Science, and Psych Info databases from inception to November 2016. Publications were included that described the development and/or validation of a PRO instrument assessing satisfaction and/or quality of life in LE trauma, applicable to both amputation and reconstruction. Two authors independently reviewed each full-text citation.
After removing duplicates, 6,290 abstracts were identified via the database query. Following a preliminary title and abstract screen, 657 full-text citations were reviewed. Of these references, none satisfied the previously established inclusion criteria.
No studies were identified that described a PRO instrument developed to assess outcomes in LE trauma patients applicable to both reconstruction and amputation. There is thus a need for a PRO instrument designed specifically for patients who have sustained limb-threatening LE trauma to guide treatment decisions.
骨折固定和软组织覆盖技术的进步持续改善了下肢（LE）严重创伤患者的治疗效果。然而，关于哪种治疗选择——重建还是截肢——最为合适的争论仍在继续。许多作者试图量化这种治疗模式下的患者体验；然而，他们并未使用针对该人群的患者报告结局（PRO）工具。我们的目的是使用既定的PRO工具开发和验证指南，识别并评估专门为LE创伤开发的、适用于重建和截肢的PRO工具。
一个多学科团队采用系统评价和Meta分析的首选报告项目方法，检索了从数据库建立到2016年11月的PubMed、Medline Ovid、EMBASE、Cochrane、Medline Web of Science和Psych Info数据库。纳入的出版物描述了一种PRO工具的开发和/或验证，该工具用于评估LE创伤患者的满意度和/或生活质量，适用于截肢和重建。两名作者独立审查每篇全文引用文献。
去除重复文献后，通过数据库检索识别出6290篇摘要。经过初步的标题和摘要筛选，对657篇全文引用文献进行了审查。在这些参考文献中，没有一篇符合先前确定的纳入标准。
未发现有研究描述开发出一种用于评估LE创伤患者结局、适用于重建和截肢的PRO工具。因此，需要一种专门为遭受LE严重创伤的患者设计的PRO工具来指导治疗决策。
