Bouillon B, Neugebauer E
Surgical Clinic and II. Department of Surgery, University of Cologne, Germany.
Langenbecks Arch Surg. 1998 Aug;383(3-4):228-34. doi: 10.1007/s004230050123.
Outcome refers to the different facets of consequences resulting from an event or intervention. These consequences may be relevant for an individual patient, but also for society. There is a growing recognition that clinical research needs to define and focus on the outcomes of medical care. Outcome research should help health care professionals to better evaluate the effectiveness of specific interventions or a therapeutic concept. This broader base of evidence should then benefit the patients.
The literature was reviewed with respect to concepts of outcome research as well as results of outcome research after major trauma.
Measuring outcome might be relevant for research purposes as well as in daily surgical practice. In the past, clinical research in trauma care has tended to focus on survival. Mortality rates are not out, complication rates are not out, but their value is limited and restricted to given scenarios with high mortality rates. New outcomes have to be added: such a functional status, emotional health, social interaction, cognitive function, degree of disability and other indicators of health.
Despite differences in injury pattern and severity of injury, there is strong evidence from the literature that the quality of life is significantly impaired after major trauma. This is true for functional outcome as well as for psycho-social outcome in up to 70% of patients.
结果是指事件或干预所产生的后果的不同方面。这些后果可能与个体患者相关，也与社会相关。人们越来越认识到临床研究需要界定并关注医疗护理的结果。结果研究应有助于医疗保健专业人员更好地评估特定干预措施或治疗理念的有效性。这种更广泛的证据基础应使患者受益。
对有关结果研究的概念以及重大创伤后结果研究的结果的文献进行了综述。
测量结果可能与研究目的以及日常外科实践相关。过去，创伤护理的临床研究倾向于关注生存率。死亡率并非唯一指标，并发症发生率也并非唯一指标，但其价值有限，且仅限于死亡率高的特定情况。必须增加新的结果指标：如功能状态、情绪健康、社会交往、认知功能、残疾程度以及其他健康指标。
尽管损伤模式和损伤严重程度存在差异，但文献中有强有力的证据表明，重大创伤后生活质量会受到显著损害。在高达70%的患者中，功能结果以及心理社会结果都是如此。
