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探索创伤患者的长期残疾结局:研究方案。

Exploring the long-term disability outcomes in Trauma patients: study protocol.

作者信息

Shaukat Natasha, Merchant Asma Altaf Hussain, Sahibjan Fazila, Abbasi Ayesha, Jarrar Zeerak, Ahmed Tanveer, Atiq Huba, Khan Uzma Rahim, Khan Nadeem Ullah, Mushtaq Saima, Rasul Shahid, Hyder Adnan A, Razzak Junaid, Haider Adil

机构信息

Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, USA.

Centre of Excellence for Trauma and Emergencies, Aga Khan University, Karachi, Pakistan.

出版信息

Arch Public Health. 2024 Oct 23;82(1):189. doi: 10.1186/s13690-024-01385-3.

Abstract

OBJECTIVES

Trauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury.

METHODS

We will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant's socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes.

DISCUSSION

The trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes.

摘要

目的

创伤登记系统是提高创伤护理质量和效率的重要工具,但许多系统未能收集患者报告的长期结局指标(PROMs)。关注这些结局对于了解患者的残疾程度以及确定潜在的出院后干预措施以优化康复至关重要。反映低收入和中等收入国家在这一领域经验的研究有限。因此,我们旨在在巴基斯坦开发一个数字创伤登记系统,以前瞻性地收集受伤后1个月、3个月、6个月和12个月时患者报告的结局指标。

方法

我们将在巴基斯坦卡拉奇的两家三级医疗机构——阿迦汗大学医院和真纳研究生医学中心开发并实施一个数字创伤登记系统。该登记系统将纳入所有入院的成年创伤患者(≥18岁)。数据收集将通过平板电脑以数字方式进行,主要结局包括死亡率、残疾程度、功能状态和生活质量。随访数据将通过对患者及其护理人员的电话访谈收集。我们将采用描述性统计来总结参与者的社会人口统计学和临床特征。此外,我们将使用Kaplan-Meier曲线和Cox比例风险模型进行生存分析,并利用混合效应线性回归来调整主要结局的潜在混杂因素。

讨论

创伤登记系统将填补低收入和中等收入国家(LMICs)创伤患者长期结局方面目前的知识空白。本研究将描绘出未来收集出院后数据的方向,增强我们对康复的理解,并为旨在改善长期结局的干预措施设计提供信息。

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本文引用的文献

1
Measuring long-term outcomes after injury: current issues and future directions.测量损伤后的长期结果:当前问题与未来方向。
Trauma Surg Acute Care Open. 2023 Mar 10;8(1):e001068. doi: 10.1136/tsaco-2022-001068. eCollection 2023.

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