Background
Methods
Data sources and search strategy
Selection criteria
Data extraction
Results
Literature search
Study characteristics
Author, year, country | Study population | HRQL instrument (mode of administration) | Follow up (time points and response rates) | Changes over time | Predictors for HRQL |
---|---|---|---|---|---|
Meerding, 2004, Netherlands [35] | ED and/or admitted Age 15+ (n = 4639) | EQ-5D (Self-completed) | 2 months (39%) 5 months (24%) 9 months (12%) | Improvements between 2 and 5 months, no further improvement between 5 and 9 months | HRQL associated with body region injured |
Polinder, 2005, Netherlands [36] | ED and/or admitted Age 5-14 (n = 1221) | EQ-5D (Self-completed, age < 13 proxy) | 2.5 month (43%) 5 months (31%) 6 months (30%) | Improvements between 2.5 and 5 months, and between 5 and 9 months | Hospital admission and female gender were predictive for long-term HRQL |
Polinder, 2007, Netherlands [37] | ED and/or admitted Age: >14 (n = 8564) | EQ-5D (Self-completed) | 2.5 month (37%) 5 months (28%) 9 months (27%) 24 months (21%) | Improvement among non admitted patients until 5 months, and among admitted patients until 24 months | Hospitalization, age and sex (females), type of injury and comorbidity were significant predictors of poor functioning in the long term |
Vasquez, 1996, Spain [56] | Admitted ICU patients (n = 351) | GOS (Self-completed) | Admission 1 year 2 year (% not available) | Quality of life improved the first year and between 1 and 2 years, but after 2 years still below pre-admission summary scores | Long-term HRQL was associated with age, injury severity, and previous quality of life |
Hetherington, 1995, UK [28] | Trauma helicopter patients (n = 100) | FIM (Face to face interviews) | Acute 3 months 6 months (93%) | Improvements in mobility and self care between 3 and 6 months | HRQL associated with length of hospital stay |
Gofin, 1997, Israel [57] | Age 4-17 (n = 281) | ICIDH (Telephone parent interviews) | Immediately 6 months (85%) | Improvements until 6 months after injury | HRQL is positively associated with ISS |
Gofin, 1995, Israel [58] | Age 0-17 (n = 432) | ICIDH (Telephone parent interviews) | Immediately 6 months (85%) | Improvements until 6 months after injury | HRQL associated with child's age and parental proxy age |
Holbrook, 1998, US [14] | >24 hours admitted in trauma center Age 18+ GCS >11 (n = 1048) | QWB-scale (Face to face interviews) | Pre-injury Discharge 6 months (79%) | Significant degree of functional limitations at discharge compared to pre-injury scores. | Post-injury depression, PTSD, serious extremity injury, and length of stay were significant predictors of HRQL |
Holbrook, 1999, US [15] | >24 hours admitted in trauma center Age 18+ GCS >11 (n = 1048) | QWB-scale (Face to face interviews) | Pre-injury Discharge (79%) 12 months (79%) 18 months (74%) | Improvement between discharge and 12 months, but no improvements between 12 and 18 months. | Post-injury depression, PTSD, serious extremity injury, and intensive care unit days were significant independent predictors of HRQL |
Holbrook, 2004, US [16] | >24 hours admitted in trauma center Age 18+ GCS >11 (n = 1048) | QWB-scale (Face to face interviews) | Discharge (79%) 6 months (79%) 12 months (74%) 18 months (74%) | Improvement between 6 and 12 months | Gender (women) was a significant independent predictors of HRQL at all follow-up time points |
Gabbe, 2007, Australia [31] | Admitted Age 18 -64 (n = 1033) | SF-12 (Telephone interviews) | Pre-injury 12 months (69%) | After 12 months patients were not returned to their pre-injury status | Compensable patients were more likely than non-compensable patients to report moderate to severe HRQL |
Brenneman, 1997, Canada [59] | Admitted ISS >10 (N = 195) | SF-36 (Telephone interviews) | Discharge (56%) 12 months (44%) | Improvements between discharge and 12 months | Better scores on 7 dimensions of the SF-36 for patients who returned to work |
Michaels, 1999, US [20] | Admitted to trauma centre Age 18+ (n = 247) | SF-36 (Self-completed) | Admission (100%) 6 months (75%) 12 months (51%) | Improvements between baseline and 6 months, and between 6 and 12 months | Mental health (PTSD) is an independent predictor of HRQL |
Kopjar, 1996, Norway [60] | Treated for injury Age 16-78 (n = 775) | SF-36 (Self-completed) | 6-10 weeks (61%) 24-28 weeks (63%) | Improvements between 2 and six months | HRQL associated with activity restrictions |
Macpherson, 2003, Canada [39] | Hospital inpatients Age 2-15 ISS >12 (n = 489) | WeeFIM (Telephone interviews) | Discharge 6 months (73%) | Improvement between discharge and 6 months | Injury mechanism is an independent predictor of HRQL |
Aitken, 2002, US [11] | Admitted to children's hospital Age 3-18 ISS > 3 (n = 310) | CHQ PF-50, WeeFIM (Parent interview, child Self-completed) | Discharge 63%) 1 month (56%) 6 months (45%) | Improvements between 1 and 6 months | HRQL associated with level of injury severity |
Winthrop, 2005, US [21] | Admitted Age 1-18 ISS > 8 (n = 180) | CHQ, FIM (Face-to-face interviews) | Discharge (90%) 1month 6 months (87%) 12 months | Improvements between baseline and 1 month, and between 1 and 6 months | HRQL associated with injury severity |
Survivors of major trauma Admitted >3 days Age 5+ (n = 251) | FIM, GOS (Telephone interviews) | 3 months (80%) 6 months 12 months > 24 months | Improvements between 3 and 6 months No further improvement between 6 months and 1 year | HRQL associated with major vs. minor injury and body region injured | |
Gillen, 2004, US [13] | Age 20+ (n = 114) | SF-36, HAQ (Telephone interviews) | 1 week 2 weeks 1 month 3 months (79%) | Improvements between 1 week and 2 weeks, between 2 weeks and 1 month, and between 1 and 3 months. | The SF-36 and the HAQ were responsive to clinical changes in varying conditions and the SF-36 was sensitive to changes in traumatic injuries. |
Kiely, 2006, US [18] | Age 18-55 ISS > 8 and all patients with age 55+ (n = 312) | SF-36, FIM (Telephone interview or self-completed) | 1 month (63%) 6 months (39%) | Improvements between 1 and 6 months post injury | Functional status, PTSD, social support, and depression were predictors of HRQL |
Soberg, 2007, Norway [43] | Admitted to trauma centre ISS > 15 Age 18-67 (n = 169) | SF-36, WHODASH II (Self-completed) | 6 weeks (62%) 1 year (61%) 2 years (60%) | Improvements, except for mental and general health between 6 wk and1 year. Between 1 and 2 years almost no improvements. | Profession, injury severity, pain, and physical, cognitive, and social functioning made independent contributions to WHODAS II 2 years after injury |
Evanoff, 2002, US [12] | Workers > 5 days workdays lost (n = 934) | SF-36, SF-12, DASH short version (Face to face interviews) | Baseline (33%) 6 months (27%) | Improvement over 6 months, after 6 months continuing HRQL | No |
Watson, 2005, Australia [33] | Admitted Age 18-74 (n = 221) | SF-36, AQol, SF-6D (Face-to-face interviews) | Pre-injury 1, 6, 12 weeks 6 months 12 months (84%) | Significant improvement of functional outcome till 6 months; no significant difference in summary scores at 6 and 12 months post-injury | The AQoL showed good discrimination between groups for type of injury, body region injured and severity of injury |
Watson, 2007, Australia [33] | Admitted Age 18-74 (n = 186) | SF-36, AQol, SF-6D (Face-to-face interviews) | Pre-injury 12 months (88%) | No difference between summary scores at baseline and 12 months after injury for patients that completely recovered | Gender, age, working status were predictors for complete recovery after one year |
Gabbe, 2008, Australia [32] | Age 15-80 ISS > 15 (n = 243) | FIM, Modified FIM, GOS, GOS-E (Telephone interviews with participants or care provider) | Discharge 6 months (97%) | Improvement between discharge and 6 months, except for the cognition component of the FIM | HRQL associated with discharge destination and head injury vs. no head injury |
Sutherland, 2005, UK [29] | Admitted Age 16-70 (n = 200) | SF-36, SF-6D, MFA, GHQ (Self-completed) | 2 months (79%) 6 months (75%) | No improvement between 2 and 6 months | No |
Author, year, country | Study population | HRQL instrument (mode of administration) | Follow up (response rates) | Predictors for HRQL |
---|---|---|---|---|
Braithwaite, 1998, UK [26] | Severe injuries ISS > 15 Age 15+ (n = 212) | BDS (Face to face interview) | 5 years (75%) | HRQL associated with body region injured |
Korosec, 2006, Slovenia [61] | ICU patients (n = 98) | EQ5D (Telephone interview) | 2 years (% not available) | No |
Aitken, 1999, US and Canada [22] | Hospitalized Age 7-18 (n = 13649) | FIM (Filled out by doctors) | Discharge (80%) | Functional outcome associated with type of injury. Lower extremity fractures caused more limitations at discharge as compared to other injuries |
Evans, 2003, UK [27] | Age 11-24 ISS > 15 (n = 125) | OPCS (Face to face interview) | 5 years (87%) | Not measured |
Holtslag, 2007, Netherlands [34] | Age 16+ ISS > 15 (n = 359) | SIP (Self-completed) | Between 12-18 months (93%) | Age, comorbidity, and type of injury were predictors of HRQL |
MacKenzie, 2002, US [19] | Admitted > 72 hours or to ICU Aga 18-59 years (n = 1587) | SF-36 + cognitive functioning scale (Face to face interview) | 12 months (78%) | Cognitive functioning and head injury were predictors of HRQL |
Alves, 2009, Brazil [62] | ED and admitted >24 hours Age 16-65 GCS > 9 and ISS > 5 (n = 35) | WHOQOL-BREF (face-to-face interview) | 6 months (88%) | Hospitalization, age, and sex were predictors for functional impairment in the physical domain |
Airey, 2001, UK [23] | Admitted survivors of major trauma ISS > 15 (n = 367) | SF-36, OPCS (Face to face interviews) | 5 years (84%) | HRQL associated with injury severity and general health perception |
Pirente, 2001, Germany [63] | Admitted and 'severely injured' (n = 56) | SF-36, TOP (Telephone interview or self-completed) | 12 months (77%) | HRQL among trauma patients higher than control group on al SF-36 dimensions (no injury) |
Holtslag, 2008, Netherlands [64] | Age 16+ ISS > 15 (n = 359) | GOS, EQ-5D (self-completed) | Between 12-18 months (93%) | Injury type and comorbidity were significantly associated with HRQL |
Janssens, 2009, Netherlands [38] | Admitted to trauma center Ag < 16 ISS > 15 (n = 40) | GOS and GOSE, AMA guides (Self-completed and face-to-face interview) | 7 years (70%) | Good discrimination could be made between respondents with different levels of functional impairment |
Dimopoulou, 2004, Greece [65] | Admitted multiple trauma patients (n = 117) | GOS, NHP, RDS (Telephone interview) | 12 months (74%) | HRQL associated with injury severity ISS and severe head trauma were independent predictors of poor HRQL |
Keyes, 2001, US [17] | Workers with > 3 days work loss (n = 402) | SF-36, HAQ, QOL (Telephone interview or self-completed) | 2 years (93%) | No |
Stalp, 2001, Germany [66] | Admitted ISS > 15 (n = 150) | SF-12, FIM, GOS, MFA (Self-completed) | 24 months (81%) | HRQL associated with body region injured |
Stalp, 2002, Germany [67] | Admitted ISS > 15 (n = 312) | SF-12, FIM, GOS, MFA (Self-completed) | 24 months (81%) | HRQL associated with body region injured (highest for lower extremity injury) |
Measurement of health related quality of life
Study design
Predictors for HRQL
Changes over time
Study | Instrument | Sample size (n) | time point | Index mean (SD) | Study population |
---|---|---|---|---|---|
ALL INJURY PATIENTS | |||||
Keyes, US [19] | QOL | 854 | 24 months | 0.70 | Adults |
Meerding, Netherlands [36] | EQ-5D | 2904 | 2.5 months | 0.86 | all injury, age 15+ |
2.5 months | 0.63 | hospitalized 15+ | |||
5 months | 0.74 | hospitalized 15+ | |||
9 months | 0.74 | hospitalized 15+ | |||
Polinder, Netherlands [3] | EQ-5D | 525 | 2.5 months | 0.92 | all injury, age 4-15 |
379 | 5 months | 0.96 | all injury, age 4-15 | ||
366 | 9 months | 0.98 | all injury, age 4-15 | ||
Polinder. Netherlands [37] | EQ-5D | 3231 | 2.5 months | 0.60 | all injury, age 15+ |
5 months | 0.70 | all injury, age 15+ | |||
9 months | 0.76 | all injury, age 15+ | |||
24 months | 0.73 | all injury, age 15+ | |||
Sutherland, UK [32] | SF-6D | 200 | 2 months | 0.61 | Admitted, age 16-70 |
6 months | 0.62 | Admitted, age 16-70 | |||
Watson, Australia [34] | SF-6D | 186 | pre-injury | 0.91 | Admitted, age 18-74 |
186 | 12 months | 0.73 | Admitted, age 18-74 | ||
SEVERE INJURY PATIENTS
| |||||
Gabbe, Australia [10] | HAQ | 243 | discharge | 0.44 | ISS > 15, age 15-80 |
6 months | 0.54 | ISS > 15, age 15-80 | |||
QWB | 1048 | discharge | 0.40 | GCS > 11, age 18+ | |
6 months | 0.63 | GCS > 11, age 18+ | |||
12 months | 0.67 | GCS > 11, age 18+ | |||
18 months | 0.68 | GCS > 11, age 18+ | |||
Holtslag, Netherlands [64] | EQ-5D | 335 | 15 months | 0.69 | ISS > 15, age 15+ |
Korosec, Slovenia [61] | EQ-5D | 98 | 24 months | 0.72 | ICU patients |
Soberg, Norway [11] | WHODAS II * | 105 | 6 weeks | 0.59 | ISS > 15, age 18-67 |
12 months | 0.72 | ISS > 15, age 18-67 | |||
24 months | 0.73 | ISS > 15, age 18-67 |