Brabant Trauma Registry, Network Emergency Care Brabant, Netherlands.
Department of Surgery, ETZ hospital, Tilburg, Netherlands.
Injury. 2020 Dec;51(12):2953-2961. doi: 10.1016/j.injury.2020.09.022. Epub 2020 Sep 16.
With the improved survival rates after trauma, the population of patients with disabilities increased. The knowledge about functional outcome and the relationship between health status and functional outcome is limited. The aim of the present prospective cohort study was to describe the functional outcome and health status over time, and the relationship between both.
Adult severely injured patients (ISS≥16) were included if hospitalised in Noord-Brabant within 48 h after injury between August 2015 and December 2016. The functional outcome (Glasgow Outcome Scale Extended - GOSE) and health status (EQ-5D) were measured at 1, 3, 6, 12 and 24 months after injury. Logistic and linear mixed models were used to examine functional outcome and health status over time. Measurements were divided into short- (1-3 months), mid- (6-12 months) and long-term (24 months).
In total 239 severely injured patients were included. Functional outcome and health status improved over time. Prognostic factors during two years were a longer hospital length of stay, female gender and Glasgow Coma Scale. Besides age was a prognostic factor for health status and education level for functional outcome. A higher ASA classification was a long-term prognostic factor for a lower functional outcome and a lower health status. The patients with a good functional recovery showed a significant higher EQ-5D utility score and patients with a poor functional recovery reported significant more problems in the EQ-5 domains.
There is a good relationship between the functional outcome and the health status during two years after a severe injury. It appears reliable to use functional outcome in terms of physical impairments in daily clinic to determine patients at risk for both a lower functional outcome and a lower health status over time.
随着创伤后生存率的提高，残疾患者人数增加。关于功能结果以及健康状况与功能结果之间的关系的知识有限。本前瞻性队列研究的目的是描述功能结果和健康状况随时间的变化，并探讨两者之间的关系。
纳入 2015 年 8 月至 2016 年 12 月在北布拉班特省受伤后 48 小时内住院的严重受伤成人患者（ISS≥16）。功能结果（格拉斯哥结局量表扩展-GOSE）和健康状况（EQ-5D）在受伤后 1、3、6、12 和 24 个月进行测量。使用逻辑和线性混合模型来检查功能结果和健康状况随时间的变化。测量分为短期（1-3 个月）、中期（6-12 个月）和长期（24 个月）。
共纳入 239 例严重受伤患者。功能结果和健康状况随时间改善。两年内的预后因素包括住院时间延长、女性和格拉斯哥昏迷量表。此外，年龄是健康状况的预后因素，教育水平是功能结果的预后因素。较高的 ASA 分类是功能结果较低和健康状况较低的长期预后因素。功能恢复良好的患者的 EQ-5D 效用评分显著较高，而功能恢复不良的患者在 EQ-5D 各个领域报告的问题明显更多。
严重创伤后两年内，功能结果与健康状况之间存在良好的关系。在日常临床中，使用功能结果来评估功能结果和健康状况随时间下降的风险似乎是可靠的。
