Holbrook T L, Hoyt D B, Anderson J P, Hollingsworth-Fridlund P, Shackford S R
Department of Family and Preventive Medicine, University of California, San Diego.
J Trauma. 1994 Jan;36(1):74-8.
Little is known about the degree of disability and quality of life of patients after major trauma. We conducted a prospective study to examine the incidence and predictors of functional limitation (FL). Between January 1, 1990 and March 30, 1990, 61 eligible trauma patients were enrolled in the study (admission GCS score > or = 12, LOS > 24 hours). Functional limitation after trauma was measured at discharge and 3 months after discharge using the Quality of Well-being (QWB) scale, a more sensitive index to the well end of the functioning continuum (range, 0 = death to 1.000 = optimum functioning). Functional limitation was also measured using a standard ADL scale (range, 17 = full function to 41 = maximum dysfunction). Risk factors measured were injury severity, body region, depression (CES-D) scale, and social support. Follow-up was achieved in 42 patients (70%). The mean age was 30 years, 74% were male, 52% white, 41% hispanic, and 3% other. The mean ISS was 15, with 69% blunt injuries and a mean LOS of 12 days. The QWB scores improved between discharge and follow-up; discharge mean = 0.457 (+/- 0.048), follow-up mean = 0.613 (+/- 0.118), but the mean QWB score at follow-up still reflected a significant degree of functional limitation. The mean percentage of change in QWB scores was 34.5% (+/- 25.5%) with a range of -6.34% to 103.8%. The discharge mean FDS was 29 (+/- 6.2) while the follow-up FDS mean was 17 (+/- 3.8), reflecting that most patients at follow-up reported near-perfect ADL functioning.(ABSTRACT TRUNCATED AT 250 WORDS)
对于严重创伤后患者的残疾程度和生活质量，人们了解甚少。我们进行了一项前瞻性研究，以检查功能受限（FL）的发生率和预测因素。在1990年1月1日至1990年3月30日期间，61名符合条件的创伤患者被纳入研究（入院时格拉斯哥昏迷评分≥12分，住院时间>24小时）。创伤后的功能受限在出院时和出院后3个月使用幸福质量（QWB）量表进行测量，该量表对功能连续体的良好结局更为敏感（范围为0 =死亡至1.000 =最佳功能）。功能受限也使用标准日常生活活动（ADL）量表进行测量（范围为17 =完全功能至41 =最大功能障碍）。测量的危险因素包括损伤严重程度、身体部位、抑郁（CES-D）量表和社会支持。42名患者（70%）完成了随访。平均年龄为30岁，74%为男性，52%为白人，41%为西班牙裔，3%为其他种族。平均损伤严重度评分（ISS）为15分，69%为钝性损伤，平均住院时间为12天。QWB评分在出院和随访之间有所改善；出院时平均分为0.457（±0.048），随访时平均分为0.613（±0.118），但随访时的平均QWB评分仍反映出显著程度的功能受限。QWB评分的平均变化百分比为34.5%（±25.5%），范围为-6.34%至103.8%。出院时平均FDS为29（±6.2），而随访时FDS平均分为17（±3.8），这表明大多数随访患者报告日常生活活动功能接近完美。（摘要截断于250字）
