Moksnes Håkon Øgreid, Schäfer Christoph, Rasmussen Mari Storli, Soberg Helene Lundgaard, Røise Olav, Anke Audny, Røe Cecilie, Næss Pål Aksel, Gaarder Christine, Helseth Eirik, Dahl Hilde Margrete, Hestnes Morten, Brunborg Cathrine, Andelic Nada, Hellstrøm Torgeir
Department of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, P.O. Box 1072 Blindern, N-0316 Oslo, Norway.
J Clin Med. 2023 Aug 15;12(16):5300. doi: 10.3390/jcm12165300.
This study aims to evaluate the global functional outcomes after moderate-to-severe traumatic injury at 6 and 12 months and to examine the sociodemographic and injury-related factors that predict these outcomes. A prospective cohort study was conducted in which trauma patients of all ages with a New Injury Severity Score > 9 who were discharged alive from two regional trauma centres in Norway over a one-year period (2020) were included. The Glasgow Outcome Scale Extended (GOSE) score was used to analyse the functional outcomes. Regression analyses were performed to investigate the predictors of the GOSE score. Follow-up assessments were obtained from approximately 85% of the 601 included patients at both time points. The mean (SD) GOSE score was 6.1 (1.6) at 6 months and 6.4 (1.6) at 12 months, which corresponds to an upper-moderate disability. One-half of the patients had a persistent disability at 12 months post-injury. The statistically significant predictors of a low GOSE score at both time points were more pre-injury comorbidity, a higher number of injuries, and higher estimated rehabilitation needs, whereas a thorax injury with an Abbreviated Injury Scale ≥ 3 predicted higher GOSE scores. A high Glasgow Coma Scale score at admission predicted a higher GOSE score at 6 months. This study strengthens the evidence base for the functional outcomes and predictors in this population.
本研究旨在评估中重度创伤性损伤后6个月和12个月时的整体功能结局,并探讨预测这些结局的社会人口统计学和损伤相关因素。开展了一项前瞻性队列研究,纳入了2020年在挪威两个地区创伤中心出院存活的、所有年龄且新损伤严重程度评分>9的创伤患者。采用格拉斯哥扩展预后量表(GOSE)评分分析功能结局。进行回归分析以研究GOSE评分的预测因素。在两个时间点,从601例纳入患者中约85%的患者获得了随访评估。6个月时GOSE评分的均值(标准差)为6.1(1.6),12个月时为6.4(1.6),这相当于中重度残疾。一半的患者在受伤后12个月仍存在持续性残疾。两个时间点GOSE评分低的统计学显著预测因素为更多的伤前合并症、更多的损伤数量以及更高的估计康复需求,而简明损伤量表≥3的胸部损伤预测GOSE评分更高。入院时格拉斯哥昏迷量表评分高预测6个月时GOSE评分更高。本研究强化了该人群功能结局及预测因素的证据基础。