Body region of injury: 47 publications [
2,
29‐
31,
34‐
39,
42‐
44,
46,
48,
53‐
55,
60,
63‐
76,
86,
130‐
133,
136,
140‐
143,
149,
155,
156,
159] reported on the influence of the location of injury on the HRQoL.
Injury to the extremities was an important predictor for poor HRQoL [
29‐
31,
35,
39,
42,
44,
70,
72‐
76,
131,
132,
142,
143,
149,
155,
156], with multiple extremity injuries predicting worse HRQoL, greater disability, and lower return rates to productivity on the long term [
132]. Worse physical functioning was reported in patients suffering from lower extremity injury compared to upper-extremity injury [
39]. Especially articular injuries were impactful as opposed to shaft injuries alone [
39]. More distal lesions (in feet or ankles) [
73] and traumatic amputations of the lower extremity [
39] were reported to be the most influential, and injuries around the knee joint were the primary cause of impairment in sports [
70]. Patients with fractures below the knee joint reported worse HRQoL compared to patients with fractures above it [
75]. Also, severely injured patients with foot injuries presented with worse outcomes in terms of HRQoL compared to patients without [
72]; concomitant injuries to midfoot fractures (Chopart and/or Lisfranc injuries) were associated with worse long-term HRQoL [
143]. Lower extremity injuries and orthopedic surgeries were independent predictors for daily pain and use of pain medication on the long-term [
149]. Upper extremity injury was also found to be a predictor for worse HRQoL, more disability, and reduced return to work in some studies [
31,
142,
156], especially when the brachial plexus was injured [
71].
Although some studies (
n = 10) indicated no (significant) correlation between (the severity of) head and/or neurological injuries and HRQoL [
29,
38,
46,
48,
63,
65,
67,
86,
138,
142], the majority (n = 16) of publications did [
31,
36,
37,
42,
43,
48,
54,
55,
60,
64,
66,
68,
69,
74,
136,
155]; especially mental and cognitive function were affected as well as the pain domain [
36,
43,
48,
54,
55,
64,
66,
69,
156], with an initial lower Glasgow Coma Scale (GCS) predicting worse HRQoL [
60,
68,
69]. GCS appeared to be a reliable predictor of HRQoL in some populations [
60,
68], and was negatively associated with self-reported physical health. Spinal cord injuries, paraplegia in patients, and higher modified Abbreviated Injury Scale (AIS) spine injuries resulted in poorer HRQoL [
31,
39,
60,
136,
140,
155].
Severe chest injury predicted reduced HRQoL scores after 1 month [
30] and frequent use of pain medication one-year post-injury [
149]. Flail chest in patients with multiple rib fractures was not a predictor for poor HRQoL [
141]. In patients with a flail chest, a concomitant sternum fracture was a significant predictor for worse HRQoL [
53].
Two studies found patients with injuries to the abdomen to be less likely to report poor HRQoL [
35,
142]. In addition, no significant association was found between HRQoL and pelvic fractures managed with ORIF [
138], not even with presence of acetabular, genitourinary or neurological injury [
38]. Patients with pelvic ring fractures stabilized with ORIF scored worse HRQoL scores when concomitant lower extremity injuries were present [
131]. Facial injuries and fractures predicted worse HRQoL and more cognitive limitations [
60,
155].
The number of body regions injured was significantly associated with long-term HRQoL [
133,
159].