Assessment of Patient-Reported Outcomes After Polytrauma: A Systematic Review

Abstract

Background: Tools assessing patient-reported outcomes (PROs) after polytrauma have not been systematically reviewed so far. Therefore, we sought to: (1) collect instruments that assess health-related quality of life (HRQoL), activities of daily living (ADL), and social participation during follow-up after polytrauma, (2) describe their use (e.g. frequency of application during follow-up), and (3) investigate other relevant PROs assessed in the included studies (e.g. pain, depression, anxiety).Methods: The search was conducted in MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, the trials registers ClinicalTrials.gov, and WHO ICTRP. All original empirical research published between January 2005 and April 2018 was included. Data extraction, narrative content analysis, and a critical appraisal were performed.Results: The search yielded 3496 hits and 54 publications were included in the review. Predominantly, HRQoL was assessed (in 48 of 54 publications), with Short Form-36 Health Survey (SF-36) applied most frequently. ADL and (social) participation were rarely assessed. The follow-up period lasted between 8 days and 17.5 years; assessments were performed between one and five times. Most used were a single assessment of PROs, a follow-up period of 1 to 1.5 years, and a postal survey. Other relevant PRO areas reported were function, mental disorders, and pain.Conclusions: There is a large variation in the assessment of PROs after polytrauma, impairing comparability of outcomes. First efforts to standardise the collection of PROs have been initiated, but further harmonisation between central players, such as trauma registers, is required. Definition and continuous collection of core outcome sets would improve comparability of study results, creating the basis for more targeted treatment. Additional knowledge on rarely reported PRO areas like (social) participation and social network may lead to their consideration in health services provision.Registration: PROSPERO (CRD42017060825)