Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Emergency Care Network Northern Netherlands (AZNN), Northern Netherlands Trauma Registry, Groningen, The Netherlands.
PLoS One. 2020 Jul 17;15(7):e0233226. doi: 10.1371/journal.pone.0233226. eCollection 2020.
Pelvic ring injuries are one of the most serious traumatic injuries with large consequences for the patients' daily life. During recent years, the importance of the patients' perception of their functioning and quality of life following injury has increasingly received attention. This systematic review reports on self-reported physical functioning and quality of life after all types of pelvic ring injuries.
The online databases MEDLINE-PubMed and Ovid-EMBASE were searched for studies published between 2008 and 2019 to identify published evidence of patient-reported physical functioning and quality of life after which they were assessed for their methodological quality.
Of the 2577 articles, 46 were reviewed in full-text, including 3049 patients. Most studies were heterogeneous, with small cohorts of patients, a variety of injury types, treatment methods and use of different, often non-validated, outcome measures. The overall methodological quality was moderate to poor. Nine different PROMs were used, of which the Majeed Pelvic Score (MPS), SF-36 and EQ-5D were the most widely used. Mean scores respectively ranged from 75-95 (MPS), 53-69 (SF-36, physical functioning) and 0.63-0.80 (EQ-5D).
Physical functioning and quality of life following pelvic ring injuries seem fair and tend to improve during follow-up. However, differences in patient numbers, injury definition, treatment strategy, follow-up duration and type of PROMs used between studies hampers to elucidate the actual effects of pelvic ring injuries on a patient's life.
Physicians and researchers should use valid and reliable patient-reported outcome instruments on large cohorts of patients with properly defined injuries to truly evaluate physical functioning and quality of life after pelvic ring injuries.
PROSPERO International prospective register of systematic reviews; registration number CRD42019129176.
骨盆环损伤是最严重的创伤之一,对患者的日常生活有很大影响。近年来,患者对受伤后身体功能和生活质量的感知越来越受到重视。本系统综述报告了各种类型骨盆环损伤后患者自我报告的身体功能和生活质量。
在线数据库 MEDLINE-PubMed 和 Ovid-EMBASE 搜索了 2008 年至 2019 年期间发表的研究,以确定患者报告的身体功能和生活质量的发表证据,然后对其进行方法学质量评估。
在 2577 篇文章中,有 46 篇进行了全文审查,共纳入 3049 名患者。大多数研究存在异质性,患者队列较小,损伤类型、治疗方法和使用不同的、往往未经验证的结局测量方法多种多样。整体方法学质量为中等至较差。使用了 9 种不同的 PROMs,其中 Majeed 骨盆评分(MPS)、SF-36 和 EQ-5D 使用最广泛。平均得分分别为 75-95(MPS)、53-69(SF-36,身体功能)和 0.63-0.80(EQ-5D)。
骨盆环损伤后患者的身体功能和生活质量似乎尚可,且在随访中趋于改善。然而,由于研究之间患者人数、损伤定义、治疗策略、随访时间和使用的 PROM 类型存在差异,妨碍了对骨盆环损伤对患者生活实际影响的阐明。
医生和研究人员应该在适当定义损伤的大量患者中使用有效和可靠的患者报告结局工具,以真正评估骨盆环损伤后的身体功能和生活质量。
PROSPERO 国际前瞻性系统评价注册库;注册号 CRD42019129176。