From the Center for Surgery and Public Health (J.P.H.-E., S.Y.O., S.D., A.T., C.P.O., M.C.-A., A.R., E.R., M.P.J., A.H.H.), Brigham and Women's Hospital, Harvard Medical School and Harvard T.H. Chan School of Public Health; Division of Trauma, Burn and Surgical Critical Care (J.P.H.-E., M.C.-A.), Connors Center for Women's Health & Gender Biology (S.Y.O.), Brigham and Women's Hospital, Boston, Massachusetts; Office of the Dean, Aga Khan University Medical College (M.B.J., M.A.A., A.H.H.), Karachi, Pakistan; Department of Surgery (D.N., E.M.B.), University of Washington, Seattle, Washington; and Coalition for National Trauma Research (M.A.P.), San Antonio, Texas.
J Trauma Acute Care Surg. 2021 May 1;90(5):891-900. doi: 10.1097/TA.0000000000003108.
The aim of this scoping review is to identify and summarize patient-reported outcome measures (PROMs) that are being used to track long-term patient-reported outcomes (PROs) after injury and can potentially be included in trauma registries.
Online databases were used to identify studies published between 2013 and 2019, from which we selected 747 articles that involved survivors of acute physical traumatic injury aged 18 years or older at time of injury and used PROMs to evaluate recovery between 6 months and 10 years postinjury. Data were extracted and summarized using descriptive statistics and a narrative synthesis of the results.
Most studies were observational, with relatively small sample sizes, and predominantly on traumatic brain injury or orthopedic patients. The number of PROs assessed per study varied from one to 12, for a total of 2052 PROs extracted, yielding 74 unique constructs (physical health, 25 [34%]; mental health, 27 [37%]; social health, 12 [16%]; cognitive health, 7 [10%]; and quality of life, 3 [4%]). These 74 constructs were assessed using 355 different PROMs. Mental health was the most frequently examined outcome domain followed by physical health. Health-related quality of life, which appeared in more than half of the studies (n = 401), was the most common PRO evaluated, followed by depressive symptoms. Physical health was the domain with the highest number of PROMs used (n = 157), and lower-extremity functionality was the PRO that contributed most PROMs (n = 33).
We identified a wide variety of PROMs available to track long-term PROs after injury in five different health domains: physical, mental, social, cognitive, and quality of life. However, efforts to fully understand the health outcomes of trauma patients remain inconsistent and insufficient. Defining PROs that should be prioritized and standardizing the PROMs to measure them will facilitate the incorporation of long-term outcomes in national registries to improve research and quality of care.
Systematic Reviews & Meta-analyses, Level IV.
本范围综述的目的是识别和总结目前用于跟踪损伤后长期患者报告结局（PRO）并可能纳入创伤登记处的患者报告结局测量（PROM）。
使用在线数据库检索 2013 年至 2019 年期间发表的研究，从中选择了 747 篇涉及急性身体创伤性损伤幸存者的文章，这些患者在损伤时年龄为 18 岁或以上，使用 PROM 来评估损伤后 6 个月至 10 年的恢复情况。使用描述性统计和结果的叙述性综合来提取和总结数据。
大多数研究为观察性研究，样本量相对较小，主要针对创伤性脑损伤或骨科患者。每项研究评估的 PRO 数量从一个到 12 个不等，共提取了 2052 个 PRO，产生了 74 个独特的结构（身体健康 25 个[34%]；心理健康 27 个[37%]；社会健康 12 个[16%]；认知健康 7 个[10%]；生活质量 3 个[4%]）。这 74 个结构使用 355 个不同的 PROM 进行了评估。心理健康是最常检查的结果领域，其次是身体健康。健康相关生活质量在超过一半的研究（n = 401）中出现，是评估最多的 PRO，其次是抑郁症状。身体健康是使用最多 PROM 的领域（n = 157），下肢功能是贡献最多 PROM 的 PRO（n = 33）。
我们确定了广泛的 PROM 可用于跟踪五个不同健康领域的损伤后长期 PRO：身体、心理、社会、认知和生活质量。然而，全面了解创伤患者的健康结果仍然不一致且不足。确定应优先考虑的 PRO 并标准化测量它们的 PROM 将有助于将长期结果纳入国家登记处，以改善研究和护理质量。
系统评价和荟萃分析，IV 级。
