Department of Trauma Surgery, Trauma Unit, Amsterdam University Medical Center, Location Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur J Trauma Emerg Surg. 2024 Feb;50(1):93-106. doi: 10.1007/s00068-023-02276-y. Epub 2023 May 15.
It is increasingly recognized that health-related quality of life (HRQoL) is a relevant outcome to study in populations comprising severely injured patients. Although some studies have readily demonstrated a compromised HRQoL in those patients, evidence regarding factors that predict HRQoL is scarce. This hinders attempts to prepare patient-specific plans that may aid in revalidation and improved life satisfaction. In this review, we present identified predictors of HRQoL in patients that have suffered severe trauma.
The search strategy included a database search until the 1st of January 2022 in the Cochrane Library, EMBASE, PubMed, and Web of Science, and reference checking. Studies were eligible for inclusion when (HR)QoL was studied in patients with major, multiple, or severe injury and/or polytrauma, as defined by authors by means of an Injury Severity Score (ISS) cut-off value. The results will be discussed in a narrative manner.
A total of 1583 articles were reviewed. Of those, 90 were included and used for analysis. In total, 23 possible predictors were identified. The following parameters predicted reduced HRQoL in severely injured patients and came forward in at least more than three studies: higher age, female gender, lower extremity injuries, higher rate of injury severity, lower achieved educational level, presence of (pre-existing) comorbidities and mental illness, longer duration of hospital stay, and high level of disability.
Age, gender, injured body region, and severity of injury were found to be good predictors of health-related quality of life in severely injured patients. A patient-centered approach, based on individual, demographic, and disease-specific predictors, is highly recommended.
人们越来越认识到，健康相关生活质量（HRQoL）是研究严重受伤患者人群的一个相关结果。尽管一些研究已经充分证明了这些患者的 HRQoL 受损，但预测 HRQoL 的因素的证据却很少。这阻碍了制定特定于患者的计划的尝试，这些计划可能有助于患者康复和提高生活满意度。在这篇综述中，我们提出了严重创伤患者 HRQoL 的预测因素。
搜索策略包括在 Cochrane Library、EMBASE、PubMed 和 Web of Science 数据库中进行截至 2022 年 1 月 1 日的数据库搜索，并进行参考文献检查。只有当（HR）QoL 是在有重大、多处或严重损伤和/或多发伤的患者中研究的，并且作者通过损伤严重程度评分（ISS）截断值定义时，研究才符合纳入标准。结果将以叙述的方式进行讨论。
共审查了 1583 篇文章。其中 90 篇被纳入并用于分析。总共确定了 23 个可能的预测因素。以下参数预测了严重受伤患者的 HRQoL 降低，并在至少三项研究中出现：年龄较大、女性、下肢损伤、更高的损伤严重程度率、较低的实际教育水平、存在（预先存在的）合并症和精神疾病、住院时间延长和残疾程度较高。
年龄、性别、受伤身体部位和损伤严重程度被发现是严重受伤患者健康相关生活质量的良好预测因素。建议基于个体、人口统计学和疾病特异性预测因素的患者为中心的方法。
