创伤系统实施对患者生活质量和经济负担的影响：一项系统评价研究方案
The Impact of Trauma System Implementation on Patient Quality of Life and Economic Burden: A Systematic Review Study Protocol.
作者信息
Bath Michael F, Kohler Katharina, Hobbs Laura, Kuhn Isla, Nabulyato William M, Kwizera Arthur, Walker Laura E, Wilkins Tom, Stubbs Daniel, Halimah Sara, Burnstein Rowan, Kolias Angelos G, Hutchinson Peter, Clarkson John, Bashford Tom
机构信息
NIHR Global Health Research Group on Acquired Brain and Spine Injury, Department of Engineering & Division of Anaesthesia, University of Cambridge, Cambridge, UK.
World Health Organisation Trauma Operational and Advisory team, UK.
出版信息
Int J Surg Protoc. 2023 Feb 9;27(1):84-89. doi: 10.29337/ijsp.187. eCollection 2023.
BACKGROUND
Trauma accounts for 10% of global mortality, with increasing rates disproportionally affecting low- and middle-income countries. In an attempt to improve clinical outcomes after injury, trauma systems have been implemented in multiple countries over recent years. However, whilst many studies have subsequently demonstrated improvements in overall mortality outcomes, less is known about the impact trauma systems have on morbidity, quality of life, and economic burden. This systematic review seeks to assess the existing evidence base for trauma systems with these outcome measures.
METHODS
This review will include any study that assesses the impact implementation of a trauma system has on patient morbidity, quality of life, or economic burden. Any comparator study, including cohort, case-control, and randomised controlled studies, will be included, both retrospective or prospective in nature. Studies conducted from any region in the world and involving any age of patient will be included. We will collect data on any morbidity outcomes, health-related quality of life measures, or health economic assessments reported. We predict a high heterogeneity in these outcomes used and will therefore keep inclusion criteria broad.
DISCUSSION
Previous reviews have shown the significant improvements that can be achieved in mortality outcomes with the implementation of an organised trauma system, however the wider impact they can have on morbidity outcomes, quality of life measures, and the economic burden of trauma, is less well described. This systematic review will present all available data on these outcomes, helping to better characterise both the societal and economic impact of trauma system implementation.
HIGHLIGHTS
Trauma systems are known to improve mortality rates, however less in known on the impact they have on morbidity outcomes, quality of life, and economic burdenWe aim to perform a systematic review to identify any comparator study that assesses the impact implementation of a trauma system on these outcomesUnderstanding the impact trauma systems can have on wider parameters, such as economic and quality of life outcomes, is crucial to allow governments globally to appropriately allocate often limited healthcare resources. CRD42022348529.
背景
创伤占全球死亡率的10%，其发生率的上升对低收入和中等收入国家的影响尤为严重。近年来，为了改善创伤后的临床结局，多个国家已实施了创伤系统。然而，尽管许多研究随后证明了总体死亡率结局有所改善，但关于创伤系统对发病率、生活质量和经济负担的影响却知之甚少。本系统评价旨在评估以这些结局指标为依据的创伤系统的现有证据基础。
方法
本评价将纳入任何评估创伤系统实施对患者发病率、生活质量或经济负担影响的研究。任何比较研究，包括队列研究、病例对照研究和随机对照研究，无论其性质是回顾性还是前瞻性，均将纳入。世界任何地区开展的、涉及任何年龄患者的研究都将纳入。我们将收集所报告的任何发病率结局、与健康相关的生活质量指标或健康经济评估数据。我们预计所使用的这些结局存在高度异质性，因此将保持纳入标准宽泛。
讨论
先前的评价表明，实施有组织的创伤系统可在死亡率结局方面取得显著改善，然而，它们对发病率结局、生活质量指标和创伤经济负担的更广泛影响却鲜有描述。本系统评价将呈现关于这些结局的所有可用数据，有助于更好地描述创伤系统实施的社会和经济影响。
要点
创伤系统已知可提高死亡率，但对其对发病率结局、生活质量和经济负担的影响了解较少。我们旨在进行一项系统评价，以确定任何评估创伤系统实施对这些结局影响的比较研究。了解创伤系统对更广泛参数（如经济和生活质量结局）的影响，对于全球各国政府合理分配往往有限的医疗资源至关重要。CRD42022348529。
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