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European Journal of Trauma and Emergency Surgery

Erschienen in:

13.11.2019 | Review Article

Injury-related variation in patient-reported outcome after musculoskeletal trauma: a systematic review

verfasst von: Abhiram R. Bhashyam, Quirine M. J. van der Vliet, Yassine Ochen, Marilyn Heng, Luke P. H. Leenen, Falco Hietbrink, Roderick M. Houwert

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2020

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Abstract

Purpose

The purpose of this study was to explore injury-related characteristics that differentiate between patient-reported outcomes (PROs) following traumatic musculoskeletal injury.

Methods

We reviewed English-language articles in PubMed/MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews (January 1995 to September 2018). We included studies that compared patient-reported outcomes of musculoskeletal trauma based on injury characteristics, and excluded studies related to development or validation of outcome tools without implementation, measurement, or comparison. Studies on patients with isolated neurotrauma or spine trauma were not included. Study level of evidence was assessed by 2 reviewers using the modified Oxford Centre for Evidence-based Medicine rating system.

Results

A total of 20 studies (21 articles) that reported on a total of 10,186 patients were included (4 were prospective cohort-studies, 8 were matched-control retrospective cohort-studies, and 8 were retrospective cohort-studies). Median minimum follow-up was 3 years (range 0.5–10 years). Injury-related factors associated with worse PROs were polytrauma or multiple injuries (10 studies), neurotrauma (11 studies), and high-energy injury mechanism (7 studies). Among all studies, 32 different outcome metrics were used (17 general health status metrics and 15 limb-specific metrics) making meta-analysis infeasible.

Conclusions

Based on the included studies, we propose a framework where musculoskeletal injuries occur in one of 4 scenarios that is associated with a different context-dependent outcome: (1) polytrauma with neurotrauma, (2) polytrauma without neurotrauma, (3) high-energy monotrauma, and (4) low-energy monotrauma. Our results suggest that standardization of outcome instruments is needed to facilitate future meta-analyses that assess PROs in this population.

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Titel: Injury-related variation in patient-reported outcome after musculoskeletal trauma: a systematic review
verfasst von: Abhiram R. Bhashyam
Quirine M. J. van der Vliet
Yassine Ochen
Marilyn Heng
Luke P. H. Leenen
Falco Hietbrink
Roderick M. Houwert
Publikationsdatum: 13.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 4/2020
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-019-01261-8

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Injury-related variation in patient-reported outcome after musculoskeletal trauma: a systematic review

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