Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Division of Trauma, Burn, and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Ann Surg. 2021 Dec 1;274(6):913-920. doi: 10.1097/SLA.0000000000005111.
OBJECTIVE: Determine the proportion and characteristics of traumatic injury survivors who perceive a negative impact of the COVID-19 pandemic on their recovery and to define post-injury outcomes for this cohort. BACKGROUND: The COVID-19 pandemic has precipitated physical, psychological, and social stressors that may create a uniquely difficult recovery and reintegration environment for injured patients. METHODS: Adult (≥18 years) survivors of moderate-to-severe injury completed a survey 6 to 14 months post-injury during the COVID-19 pandemic. This survey queried individuals about the perceived impact of the COVID-19 pandemic on injury recovery and assessed post-injury functional and mental health outcomes. Regression models were built to identify factors associated with a perceived negative impact of the pandemic on injury recovery, and to define the relationship between these perceptions and long-term outcomes. RESULTS: Of 597 eligible trauma survivors who were contacted, 403 (67.5%) completed the survey. Twenty-nine percent reported that the COVID-19 pandemic negatively impacted their recovery and 24% reported difficulty accessing needed healthcare. Younger age, lower perceived-socioeconomic status, extremity injury, and prior psychiatric illness were independently associated with negative perceived impact of the COVID-19 pandemic on injury recovery. In adjusted analyses, patients who reported a negative impact of the pandemic on their recovery were more likely to have new functional limitations, daily pain, lower physical and mental component scores of the Short-Form-12 and to screen positive for PTSD and depression. CONCLUSIONS: The COVID-19 pandemic is negatively impacting the recovery of trauma survivors. It is essential that we recognize the impact of the pandemic on injured patients while focusing on directed efforts to improve the long-term outcomes of this already at-risk population.
目的:确定创伤幸存者中认为 COVID-19 大流行对其康复产生负面影响的比例和特征,并定义该队列的受伤后结局。
背景:COVID-19 大流行引发了身体、心理和社会压力,这可能为受伤患者创造了一个独特的困难康复和重新融入环境。
方法:在 COVID-19 大流行期间,中度至重度受伤的成年(≥18 岁)幸存者在受伤后 6 至 14 个月完成了一项调查。该调查询问了个人 COVID-19 大流行对受伤康复的感知影响,并评估了受伤后的功能和心理健康结局。建立回归模型以确定与 COVID-19 大流行对受伤康复的感知负面影响相关的因素,并定义这些感知与长期结局之间的关系。
结果:在联系的 597 名符合条件的创伤幸存者中,有 403 名(67.5%)完成了调查。29%的人报告 COVID-19 大流行对他们的康复产生了负面影响,24%的人报告难以获得所需的医疗保健。年龄较小、感知社会经济地位较低、四肢受伤和既往精神病史与 COVID-19 大流行对受伤康复的感知负面影响独立相关。在调整后的分析中,报告 COVID-19 大流行对其康复产生负面影响的患者更有可能出现新的功能障碍、日常疼痛、较低的物理和心理成分得分,以及 PTSD 和抑郁筛查阳性。
结论:COVID-19 大流行正在对创伤幸存者的康复产生负面影响。我们必须认识到大流行对受伤患者的影响,同时专注于有针对性的努力,以改善这一已经处于危险之中的人群的长期结局。
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