Long-term follow-up of patients treated for traumatic injury regarding physical and psychological function and health-related quality of life

Wihlke, Gunilla; Strömmer, Lovisa; Troëng, Thomas; Brattström, Olof

doi:10.1007/s00068-019-01170-w

Cited by 16 publications

(19 citation statements)

References 21 publications

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“…Therefore, a response rate of 56% can be considered to be relatively satisfactory. Moreover, when comparing our response rate to that reported in earlier studies, it is clear that low response rates are a common occurrence (4)(5)(6)9) in studies regarding post-injury quality of life. Furthermore, the attrition rate has been shown to become even greater as time passes by (11).…”

Section: Discussionsupporting

confidence: 58%

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The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

Riuttanen

Jokihaara²,

Huttunen³

et al. 2020

Preprint

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Background From one third up to half of all injured patients admitted to emergency rooms have a positive blood alcohol level (BAL). Frequent alcohol use also has negative effects on a person’s quality of life. Even though alcohol use among injury patients is common, the effects of pre-injury alcohol use on Health-Related Quality of Life (HR-QoL) have not previously been studied. The primary objective of this study was to evaluate whether pre-injury alcohol use has an influence on an injured patient’s HR-QoL and reported problems. A secondary objective was to compare injured patient’s HR-QoL with the population norm of Finland. Methods Retrospective analysis of all trauma patients treated at Tampere University Hospital’s (TAUH) Intensive Care Unit (ICU) or High Dependence Unit (HDU) in 2013. The following inclusion criteria were used: patient treated at TAUH’s ICU or HDU, age ≥ 18 years, NISS ≥ 16 and possesses a valid Finnish personal identification number to enable comprehensive follow-up. From a total of 373 patients, 227 patients met the inclusion criteria. HR-QoL was assessed with the EQ-5D questionnaire during the patients’ stay in the ICU/HDU and one year after the injury. The EQ-5D index value was further compared with the index values of the age-matched population norms of Finland. Results Thirty-four percent (77/227) of all patients tested positive for alcohol at the time of the injury with a mean blood alcohol content (BAC) of 1.9 g/L. Twenty-nine patients (N= 29/227) died within 1 year of injury, and therefore 198 patients were contacted for post-injury EQ-5D questionnaires. Complete data sets with both pre- and post-injury EQ-5D questionnaires were available for 111 (56%) patients. Patients with positive BAL expressed notably more anxiety and depression (45%) before trauma compared to both patients with negative BAL (11%) and the reference population of Finland (14%). Overall, pre-injury HR-QoL was also poorer in BAL positive patients than BAL negative patients. The amount of anxiety and depression in BAL positive patients decreased after injury. In both groups, the relative number of reported problems after injury exceeded the relative number of reported problems of the reference population of Finland in all five EQ-5D dimensions. Conclusions Patients with positive BAL upon admission report overall lower HR-QoL than patients with negative BAL. This finding is most likely explained by the excessive amount of anxiety and depression, which had decreased one year after injury. We speculate that this may partly be explained by a possible reduction in alcohol use, which has been reported to happen in injury patients. As has previously been reported, the impact of severe injury on post-injury QoL in general is detrimental and long-lasting and overall HR-QoL remains lower than the population norm.

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Section: Discussionsupporting

confidence: 58%

“…Moreover, it is well described that in both minor (4,5) and severe injuries (6)(7)(8)(9)(10), the injury has a signi cant negative impact on the post-injury HR-QoL of the injured person. It is also apparent that the negative effect on HR-QoL after severe injury is a long-lasting condition/phenomenon (9,11).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

Riuttanen

Jokihaara²,

Huttunen³

et al. 2020

Preprint

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“…Adult trauma services often use return to work as an indicator of recovery. 17 Similarly, in children’s trauma management parents’ return to work may be a useful indicator of recovery and the family’s return to ‘normal’.…”

Section: Discussionmentioning

confidence: 99%

The impact of injury: The experiences of children and families after a child’s traumatic injury

et al. 2020

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Objective: To explore the experiences of children and families after a child’s traumatic injury (Injury Severity Score >8). Design: Qualitative interview study. Setting: Two children’s major trauma centres in England. Participants: 32 participants: 13 children with traumatic injuries, their parents/guardians ( n = 14) and five parents whose injured child did not participate. Methods: Semi-structured interviews exploring the emotional, social, practical and physical impacts of children’s injuries, analysed by thematic analysis. Results: Interviews were conducted a median of 8.5 months (IQR 9.3) post-injury. Injuries affected the head, chest, abdomen, spine, limbs or multiple body parts. Injured children struggled with changes to their appearance, physical activity restrictions and late onset physical symptoms, which developed after hospital discharge when activity levels increased. Social participation was affected by activity restrictions, concerns about their appearance and interruptions to friendships. Psychological impacts, particularly post-traumatic stress type symptoms often affected both children and parents. Parents’ responsibilities suddenly increased, which affected family relationships and roles, their ability to work and carry out daily tasks. Rapid hospital discharge was wanted, but participants often felt vulnerable on return home. They valued continued contact with a healthcare professional and practical supports from family and friends, which enabled resumption of their usual lives. Conclusions: Injured children experience changes to their appearance, friendships, physical activity levels and develop new physical and mental health symptoms after hospital discharge. Such challenges can be addressed by the provision of advice about potential symptoms, alternative activities during recovery, strategies to build resilience and how to access services after hospital discharge.

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“…The data extracted from these studies were divided into those reporting on RTW up to 6 months and from 7 to 12 months (15 data points). Of the 14 studies (41-54) that reported on RTW up to 6 months, there were three studies (41,50,53) that had measured patients at more than one time point and two studies (43,44) that measured two groups of trauma patients. The pooled estimate of effect size was 0.52 (95% CI 0.43,0.6) (I 2 = 98.9%); i.e., 52% of the participants returned to some form of employment.…”

Section: Return-to-work (Rtw) 1a Back To Any Work (Yes or No)mentioning

confidence: 99%

“…The pooled estimate of effect size was 0.52 (95% CI 0.43,0.6) (I 2 = 98.9%); i.e., 52% of the participants returned to some form of employment. There were 14 studies (45,47,48,50,53,(55)(56)(57)(58)(59)(60)(61)(62)(63) that reported on RTW up to 12 months, one of which had reported on two groups of trauma patients. The pooled estimate of effect size was 0.64 (95% CI 0.53,0.5) (I 2 = 99.2%); i.e., 64% of the participants returned to some form of employment.…”

Section: Return-to-work (Rtw) 1a Back To Any Work (Yes or No)mentioning

confidence: 99%

Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis

David

Aroke

Roy

et al. 2022

Injury

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Long-term follow-up of patients treated for traumatic injury regarding physical and psychological function and health-related quality of life

Cited by 16 publications

References 21 publications

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

The impact of injury: The experiences of children and families after a child’s traumatic injury

Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis

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