Injury Severity and Quality of Life: Whose Perspective Is Important?

Abstract

ISS does not give the full picture of the severity of injury. Surgeons should consider early screening of patients for perception of injury severity and PTSD symptoms to determine which patients may need psychologic intervention to improve long-term QOL.

Characteristics of polytrauma patients with posttraumatic stress disorder in a level 1 trauma center

“…This reflects the mobility and diversity of the (poly)trauma patient population. High drop-out rates are not uncommon in the trauma literature, as previous studies with follow up rates of only 10% have been accepted [11]. Also, the mortality rate was high in our study.…”

“…Recent publications in the Journal of Trauma have highlighted the importance of PTSD in the outcome of physical trauma [11,12]. These articles show that the outcome of complex orthopedic trauma patients is not only determined by obvious impairment, such as an amputation, but that pain and posttraumatic stress symptoms are very significant factors in determining outcome and quality of life.…”

Escala de coma de Glasgow e qualidade de vida pós-trauma cranioencefálico

“…A recent finding regarding the severity of the trauma as perceived by the patient and QOL six months posttrauma found that the severity of the trauma as perceived by the patient influenced the post-trauma QOL more than the trauma severity estimated by anatomical indicators, such as the Injury Severity Score. The results of that study suggest that the expectations of the patient regarding the injury play a more important role in the post-trauma recovery than the actual severity (10) .…”

“…This instrument has been demonstrated to have correlation with and sensitivity to the health problems present in HT victims, suggesting that it is adequate for the subjective evaluation of QOL in this population (9,10,(13)(14)(15) . Moreover, the SF-36 possesses a question that is not part of the evaluated items and, in an isolated form, allows the recognition of the interviewee's perception, negative or positive, regarding their health (11,12) .…”

“…However, to measure the physical, psycho-social and emotional impacts caused by the trauma, a broad evaluation parameter becomes necessary that allows the identification of aspects of the individual's life that can be harmed in any way by HT (6)(7)(8) . Thus, the evaluation of the quality of life (QOL) of these patients is demonstrated in studies as an indicator of disease progression, describing how the post-trauma recovery process is being experienced from the perspective of both the patient and the family (8)(9)(10) and serving as a tool that assists with therapeutic decisions and the conduct of the health teams. Based on previous information, the objective of this study is to verify and compare the performance of GCS scores observed in the first 72 hours after BHT to predict the perceived change in the health status of these victims and to verify the association of the GCS scores and the QOL domains one year after the traumatic event.…”