Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
Qual Life Res. 2021 Dec;30(12):3511-3521. doi: 10.1007/s11136-021-02876-4. Epub 2021 May 25.
As few studies have examined long-term health after penetrating injury, this population-based registry study sought to assess health outcomes up to 24 months post-injury.
Major trauma patients with penetrating trauma (2009-2017) were included from the Victorian State Trauma Registry (N = 1,067; 102 died, 208 were lost to follow-up). The EQ-5D-3L was used to measure health status at 6, 12 and 24-months. Mixed linear and logistic regressions were used to examine predictors of summary scores, and problems versus no problems on each health dimension.
Average health status summary scores were 0.70 (sd = 0.26) at 6 and 12 months, and 0.72 (sd = 0.26) at 24 months post-injury. Prevalence of problems was consistent over time: mobility (24-26%), self-care (17-20%), usual activities (47-50%), pain/discomfort (44-49%), and anxiety/depression (54-56%). Lower health status and reporting problems was associated with middle-older age, female sex, unemployment; pre-injury disability, comorbid conditions; and assault and firearm injury versus cutting/piercing.
Problems with usual activities, pain/discomfort and anxiety or depression are common after penetrating major trauma. Risk factor screening in hospital could be used to identify people at risk of poor health outcomes, and to link people at risk with services in hospital or early post-discharge to improve their longer-term health outcomes.
由于很少有研究检查穿透性损伤后的长期健康状况,本基于人群的登记研究旨在评估受伤后长达 24 个月的健康结果。
从维多利亚州创伤登记处(2009-2017 年)纳入患有穿透性创伤的严重创伤患者(N=1067;102 例死亡,208 例失访)。使用 EQ-5D-3L 在 6、12 和 24 个月时测量健康状况。混合线性和逻辑回归用于检查各健康维度的综合评分和存在问题与无问题的预测因素。
受伤后 6 个月和 12 个月时平均健康状况综合评分分别为 0.70(标准差=0.26),24 个月时为 0.72(标准差=0.26)。各时间点的问题发生率一致:行动能力(24-26%)、自我护理(17-20%)、日常活动(47-50%)、疼痛/不适(44-49%)和焦虑/抑郁(54-56%)。中老年人、女性、失业、受伤前残疾、合并症、袭击和枪支伤与切割/刺穿伤与较低的健康状况和报告问题相关。
穿透性严重创伤后,日常活动、疼痛/不适和焦虑或抑郁方面的问题很常见。入院时进行危险因素筛查可以识别出健康状况不佳的高风险人群,并将高风险人群与医院或早期出院后的服务联系起来,以改善他们的长期健康结果。