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Erschienen in: European Journal of Trauma and Emergency Surgery 1/2021

27.05.2019 | Original Article

Quality of life after multiple trauma: results from a patient cohort treated in a certified trauma network

verfasst von: Katharina Angerpointner, Antonio Ernstberger, Katharina Bosch, Florian Zeman, Michael Koller, Maximilian Kerschbaum

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2021

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Abstract

Purpose

Besides mortality, the patient-reported outcome (PRO) in survivors of multiple trauma is of increasing interest. So far, no data on patient-reported outcome measures (PROMs) after multiple trauma from an entire trauma network are available. Within this study, the course of the PRO over time and differences between level I and level II trauma centers within an entire trauma network was evaluated.

Methods

Multiple injured patients, treated in a rural trauma network over 2 years, were prospectively included in this study. After 6, 12 and 24 months the results of the European Quality of Life (EuroQoL) EQ-5D outcome instrument were evaluated. To adjust for differences in trauma severity between level I and level II centers, the Revised Injury Severity Classification II (RISC II) and the Functional Capacity Index (FCI) were used to adjust the life-quality results of patients.

Results

501 patients were included, 118 patients with an ISS < 16 points, 383 patients reached 16 points or more. Despite a steady increase of EQ-5D index over time (6 months: 0.71 ± 0.31; 12 months: 0.74 ± 0.28; 24 months: 0.76 ± 0.27; p < 0.001), the values of a reference population could not be reached even 2 years after trauma (EQ-5D reference population: 0.9). After adjustment for trauma severity, no significant differences in PROMs between level I and level II centers could be detected (p = 0.188).

Conclusion

The consistently low EQ-5D index relative the reference population and the lack of a difference between level I and II centers suggest that improved strategies for polytrauma aftercare are called for.
Literatur
2.
Zurück zum Zitat Ruchholtz S, Lefering R, Paffrath T, Oestern H-J, Neugebauer E, Nast-Kolb D, et al. Reduction in mortality of severely injured patients in Germany. Dtsch Arztebl Int. 2008;105:225–31.PubMedPubMedCentral Ruchholtz S, Lefering R, Paffrath T, Oestern H-J, Neugebauer E, Nast-Kolb D, et al. Reduction in mortality of severely injured patients in Germany. Dtsch Arztebl Int. 2008;105:225–31.PubMedPubMedCentral
3.
Zurück zum Zitat Ernstberger A, Koller M, Zeman F, Kerschbaum M, Hilber F, Diepold E, et al. A trauma network with centralized and local health care structures: evaluating the effectiveness of the first certified Trauma Network of the German Society of Trauma Surgery. PloS one. 2018;13:e0194292.CrossRef Ernstberger A, Koller M, Zeman F, Kerschbaum M, Hilber F, Diepold E, et al. A trauma network with centralized and local health care structures: evaluating the effectiveness of the first certified Trauma Network of the German Society of Trauma Surgery. PloS one. 2018;13:e0194292.CrossRef
4.
Zurück zum Zitat Kaske S, Lefering R, Trentzsch H, Driessen A, Bouillon B, Maegele M, et al. Quality of life two years after severe trauma: a single-centre evaluation. Injury. 2014;45(Suppl 3):S100–5.CrossRef Kaske S, Lefering R, Trentzsch H, Driessen A, Bouillon B, Maegele M, et al. Quality of life two years after severe trauma: a single-centre evaluation. Injury. 2014;45(Suppl 3):S100–5.CrossRef
5.
Zurück zum Zitat Ahmed W, Alwe R, Wade D. One-year functional outcomes following major trauma: experience of a UK level 1 major trauma centre. Clin Rehabil. 2017;31:1646–52.CrossRef Ahmed W, Alwe R, Wade D. One-year functional outcomes following major trauma: experience of a UK level 1 major trauma centre. Clin Rehabil. 2017;31:1646–52.CrossRef
6.
Zurück zum Zitat Larsen P, Goethgen CB, Rasmussen S, Iyer AB, Elsoe R. One-year development of QOL following orthopaedic polytrauma: a prospective observational cohort study of 53 patients. Arch Orthop Trauma Surg. 2016;136:1539–46.CrossRef Larsen P, Goethgen CB, Rasmussen S, Iyer AB, Elsoe R. One-year development of QOL following orthopaedic polytrauma: a prospective observational cohort study of 53 patients. Arch Orthop Trauma Surg. 2016;136:1539–46.CrossRef
7.
Zurück zum Zitat Marasco S, Lee G, Summerhayes R, Fitzgerald M, Bailey M. Quality of life after major trauma with multiple rib fractures. Injury. 2015;46:61–5.CrossRef Marasco S, Lee G, Summerhayes R, Fitzgerald M, Bailey M. Quality of life after major trauma with multiple rib fractures. Injury. 2015;46:61–5.CrossRef
8.
Zurück zum Zitat Simmel S, Drisch S, Haag S, Bühren V. Long-term results after multiple trauma with ISS ≥ 25. Chirurg. 2013;84:771–9.CrossRef Simmel S, Drisch S, Haag S, Bühren V. Long-term results after multiple trauma with ISS ≥ 25. Chirurg. 2013;84:771–9.CrossRef
9.
Zurück zum Zitat von Rüden C, Woltmann A, Röse M, Wurm S, Rüger M, Hierholzer C, et al. Outcome after severe multiple trauma: a retrospective analysis. J Trauma Manag Outcome. 2013;7:973. von Rüden C, Woltmann A, Röse M, Wurm S, Rüger M, Hierholzer C, et al. Outcome after severe multiple trauma: a retrospective analysis. J Trauma Manag Outcome. 2013;7:973.
10.
Zurück zum Zitat Holtslag HR, van Beeck EF, Lindeman E, Leenen LPH. Determinants of long-term functional consequences after major trauma. J Trauma Inj Infect Crit Care. 2007;62:919–27.CrossRef Holtslag HR, van Beeck EF, Lindeman E, Leenen LPH. Determinants of long-term functional consequences after major trauma. J Trauma Inj Infect Crit Care. 2007;62:919–27.CrossRef
11.
Zurück zum Zitat Soberg HL, Bautz-Holter E, Roise O, Finset A. Long-term multidimensional functional consequences of severe multiple injuries two years after trauma: a prospective longitudinal cohort study. J Trauma Inj Infect Crit Care. 2007;62:461–70.CrossRef Soberg HL, Bautz-Holter E, Roise O, Finset A. Long-term multidimensional functional consequences of severe multiple injuries two years after trauma: a prospective longitudinal cohort study. J Trauma Inj Infect Crit Care. 2007;62:461–70.CrossRef
12.
Zurück zum Zitat Dimopoulou I, Anthi A, Mastora Z, Theodorakopoulou M, Konstandinidis A, Evangelou E, et al. Health-related quality of life and disability in survivors of multiple trauma one year after intensive care unit discharge. Am J Phys Med Rehabil. 2004;83:171–6.CrossRef Dimopoulou I, Anthi A, Mastora Z, Theodorakopoulou M, Konstandinidis A, Evangelou E, et al. Health-related quality of life and disability in survivors of multiple trauma one year after intensive care unit discharge. Am J Phys Med Rehabil. 2004;83:171–6.CrossRef
13.
Zurück zum Zitat Brooks R. EuroQol: the current state of play. Health Policy. 1996;37:53–72.CrossRef Brooks R. EuroQol: the current state of play. Health Policy. 1996;37:53–72.CrossRef
15.
Zurück zum Zitat Baker SP, OʼNeill B, Haddon WJR, Long WB. The injury severity score. J Trauma Inj Infect Crit Care. 1974;14:187–96.CrossRef Baker SP, OʼNeill B, Haddon WJR, Long WB. The injury severity score. J Trauma Inj Infect Crit Care. 1974;14:187–96.CrossRef
16.
Zurück zum Zitat Lefering R, Huber-Wagner S, Nienaber U, Maegele M, Bouillon B. Update of the trauma risk adjustment model of the TraumaRegister DGU™: The Revised Injury Severity Classification, version II. Crit Care. 2014;18:476.CrossRef Lefering R, Huber-Wagner S, Nienaber U, Maegele M, Bouillon B. Update of the trauma risk adjustment model of the TraumaRegister DGU™: The Revised Injury Severity Classification, version II. Crit Care. 2014;18:476.CrossRef
17.
Zurück zum Zitat Palmer CS, Cameron PA, Gabbe BJ. A review of the revised Functional Capacity Index as a predictor of 12 month outcomes following injury. Injury. 2017;48:591–8.CrossRef Palmer CS, Cameron PA, Gabbe BJ. A review of the revised Functional Capacity Index as a predictor of 12 month outcomes following injury. Injury. 2017;48:591–8.CrossRef
18.
Zurück zum Zitat Hinz A, Kohlmann T, Stöbel-Richter Y, Zenger M, Brähler E. The quality of life questionnaire EQ-5D-5L: psychometric properties and normative values for the general German population. Qual Life Res. 2013;23:443–7.CrossRef Hinz A, Kohlmann T, Stöbel-Richter Y, Zenger M, Brähler E. The quality of life questionnaire EQ-5D-5L: psychometric properties and normative values for the general German population. Qual Life Res. 2013;23:443–7.CrossRef
19.
Zurück zum Zitat Koller M, Ernstberger A, Zeman F, Loss J, Nerlich M, Trauma Network Eastern Bavaria (TNO). Outcome after polytrauma in a certified trauma network: comparing standard vs. maximum care facilities concept of the study and study protocol (POLYQUALY). BMC Health Serv Res. 2016;16:242.CrossRef Koller M, Ernstberger A, Zeman F, Loss J, Nerlich M, Trauma Network Eastern Bavaria (TNO). Outcome after polytrauma in a certified trauma network: comparing standard vs. maximum care facilities concept of the study and study protocol (POLYQUALY). BMC Health Serv Res. 2016;16:242.CrossRef
20.
Zurück zum Zitat Szende A, Janssen B, Cabases J, editors. Self-reported population health: an international perspective based on EQ-5D. Dordrecht: Springer Netherlands; 2014. Szende A, Janssen B, Cabases J, editors. Self-reported population health: an international perspective based on EQ-5D. Dordrecht: Springer Netherlands; 2014.
Metadaten
Titel
Quality of life after multiple trauma: results from a patient cohort treated in a certified trauma network
verfasst von
Katharina Angerpointner
Antonio Ernstberger
Katharina Bosch
Florian Zeman
Michael Koller
Maximilian Kerschbaum
Publikationsdatum
27.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 1/2021
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01160-y

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