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Erschienen in: Clinical Orthopaedics and Related Research® 9/2013

01.09.2013 | Symposium: Tscherne Festschrift

What Are Predictors for Patients’ Quality of Life After Pelvic Ring Fractures?

verfasst von: Joerg H. Holstein, MD, Antonius Pizanis, MD, Daniel Köhler, MD, Tim Pohlemann, MD, Working Group Quality of Life After Pelvic Fractures

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 9/2013

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Abstract

Background

Data from literature on predictors for patients’ quality of life after pelvic ring fractures are conflicting and based on small study populations.

Questions/purposes

We therefore evaluated predictors for health-related quality of life in patients with pelvic ring injuries at a minimum of 1 year postfracture.

Methods

We surveyed 172 patients of the German Pelvic Trauma Registry admitted to four medical centers between February 3, 2004, and May 11, 2011. The median age of the followup cohort was 47 years (range, 8–88 years); 69 of 172 (40%) patients were female. Patients were characterized by a median Injury Severity Score of 17. There were 31 Tile Type A fractures (18%), 77 Type B fractures (45%), and 64 Type C fractures (37%). The incidence of complex fractures and multiple traumas was 34 of 172 (20%) and 116 of 172 (67%), respectively. One hundred twenty-five (73%) patients were treated operatively. We obtained the EQ-5D™ score to assess patients’ health-related quality of life. For the analysis of predictors for quality of life, a multivariate linear regression model was built. The median followup was 3 years (range, 1–6 years).

Results

The median EQ-5D™ score was 0.78 (interquartile limits, 0.63 and 1.00). Age, complex trauma, and surgery independently predicted the EQ-5D™ score.

Conclusions

We conclude patients with higher age, complex trauma, and surgery had a higher likelihood for a reduced quality of life after pelvic ring injuries.

Level of Evidence

Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Aprahamian C, Wolferth CC Jr, Darin JC, McMahon J, Weitzel-DeVeas C. Status of trauma center designation. J Trauma. 1989;29:566–570.PubMedCrossRef Aprahamian C, Wolferth CC Jr, Darin JC, McMahon J, Weitzel-DeVeas C. Status of trauma center designation. J Trauma. 1989;29:566–570.PubMedCrossRef
2.
Zurück zum Zitat Ayvaz M, Caglar O, Yilmaz G, Guvendik GI, Acaroglu RE. Long-term outcome and quality of life of patients with unstable pelvic fractures treated by closed reduction and percutaneous fixation. Ulus Travma Acil Cerrahi Derg. 2011;17:261–266.PubMed Ayvaz M, Caglar O, Yilmaz G, Guvendik GI, Acaroglu RE. Long-term outcome and quality of life of patients with unstable pelvic fractures treated by closed reduction and percutaneous fixation. Ulus Travma Acil Cerrahi Derg. 2011;17:261–266.PubMed
3.
Zurück zum Zitat Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187–196.PubMedCrossRef Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187–196.PubMedCrossRef
4.
Zurück zum Zitat Culemann U, Scola A, Tosounidis G, Pohlemann T, Gebhard F. [Concept for treatment of pelvic ring injuries in elderly patients: a challenge] [in German]. Unfallchirurg. 2010;113:258–271.PubMedCrossRef Culemann U, Scola A, Tosounidis G, Pohlemann T, Gebhard F. [Concept for treatment of pelvic ring injuries in elderly patients: a challenge] [in German]. Unfallchirurg. 2010;113:258–271.PubMedCrossRef
5.
Zurück zum Zitat Draijer F, Egbers HJ, Havemann D, Zimmermann M. [Results of follow-up of conservatively and surgically treated injuries of the pelvic ring within the scope of a prospective study] [in German]. Unfallchirurg. 1995;98:355–360.PubMed Draijer F, Egbers HJ, Havemann D, Zimmermann M. [Results of follow-up of conservatively and surgically treated injuries of the pelvic ring within the scope of a prospective study] [in German]. Unfallchirurg. 1995;98:355–360.PubMed
6.
Zurück zum Zitat Eid K, Keel M, Keller A, Ertel W, Trentz O. [Influence of sacral fracture on the long-term outcome of pelvic ring injuries] [in German]. Unfallchirurg. 2005;108:35–36, 38–42. Eid K, Keel M, Keller A, Ertel W, Trentz O. [Influence of sacral fracture on the long-term outcome of pelvic ring injuries] [in German]. Unfallchirurg. 2005;108:35–36, 38–42.
7.
Zurück zum Zitat EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy. 1990;16:199–208. EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy. 1990;16:199–208.
8.
Zurück zum Zitat Gebhard F, Culemann U. [Pelvic ring injuries in the elderly] [in German]. Unfallchirurg. 2010;113:257.PubMedCrossRef Gebhard F, Culemann U. [Pelvic ring injuries in the elderly] [in German]. Unfallchirurg. 2010;113:257.PubMedCrossRef
9.
Zurück zum Zitat Hauschild O, Aghayev E, von Heyden J, Strohm PC, Culemann U, Pohlemann T, Suedkamp NP, Schmal H. Angioembolization for pelvic hemorrhage control: results from the German Pelvic Injury Register. J Trauma Acute Care Surg. 2012;73:679–684.PubMedCrossRef Hauschild O, Aghayev E, von Heyden J, Strohm PC, Culemann U, Pohlemann T, Suedkamp NP, Schmal H. Angioembolization for pelvic hemorrhage control: results from the German Pelvic Injury Register. J Trauma Acute Care Surg. 2012;73:679–684.PubMedCrossRef
10.
Zurück zum Zitat Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM. Pelvic fracture in geriatric patients: a distinct clinical entity. J Trauma. 2002;53:15–20.PubMedCrossRef Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM. Pelvic fracture in geriatric patients: a distinct clinical entity. J Trauma. 2002;53:15–20.PubMedCrossRef
11.
Zurück zum Zitat Holstein JH, Culemann U, Pohlemann T; Working Group Mortality in Pelvic Fracture Patients. What are predictors of mortality in patients with pelvic fractures? Clin Orthop Relat Res. 2012;470:2090–2097.PubMedCrossRef Holstein JH, Culemann U, Pohlemann T; Working Group Mortality in Pelvic Fracture Patients. What are predictors of mortality in patients with pelvic fractures? Clin Orthop Relat Res. 2012;470:2090–2097.PubMedCrossRef
12.
Zurück zum Zitat Kabak S, Halici M, Tuncel M, Avsarogullari L, Baktir A, Basturk M. Functional outcome of open reduction and internal fixation for completely unstable pelvic ring fractures (type C): a report of 40 cases. J Orthop Trauma. 2003;17:555–562.PubMedCrossRef Kabak S, Halici M, Tuncel M, Avsarogullari L, Baktir A, Basturk M. Functional outcome of open reduction and internal fixation for completely unstable pelvic ring fractures (type C): a report of 40 cases. J Orthop Trauma. 2003;17:555–562.PubMedCrossRef
13.
Zurück zum Zitat Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970–1997 and alarming projections for the new millennium. Osteoporos Int. 2000;11:443–448.PubMedCrossRef Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970–1997 and alarming projections for the new millennium. Osteoporos Int. 2000;11:443–448.PubMedCrossRef
14.
Zurück zum Zitat Keeter S, Kennedy C, Dimock M, Best J, Craighill P. Gauging the impact of growing nonresponse on estimates from a National RDD Telephone Survey. Public Opin Q. 2006;70:759–779.CrossRef Keeter S, Kennedy C, Dimock M, Best J, Craighill P. Gauging the impact of growing nonresponse on estimates from a National RDD Telephone Survey. Public Opin Q. 2006;70:759–779.CrossRef
15.
Zurück zum Zitat Kind P, Hardman G, Macran S. UK Population Norms for EQ-5D. York, UK: Centre for Health Economics, University of York; 1999. Kind P, Hardman G, Macran S. UK Population Norms for EQ-5D. York, UK: Centre for Health Economics, University of York; 1999.
16.
Zurück zum Zitat Morris RO, Sonibare A, Green DJ, Masud T. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards. Postgrad Med J. 2000;76:646–650.PubMedCrossRef Morris RO, Sonibare A, Green DJ, Masud T. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards. Postgrad Med J. 2000;76:646–650.PubMedCrossRef
17.
Zurück zum Zitat O’Brien D P, Luchette FA, Pereira SJ, Lim E, Seeskin CS, James L, Miller S, Davis K Jr, Hurst JM, Johannigman JA, Frame SB. Pelvic fracture in the elderly is associated with increased mortality. Surgery. 2002;132:710–714; discussion 714–715. O’Brien D P, Luchette FA, Pereira SJ, Lim E, Seeskin CS, James L, Miller S, Davis K Jr, Hurst JM, Johannigman JA, Frame SB. Pelvic fracture in the elderly is associated with increased mortality. Surgery. 2002;132:710–714; discussion 714–715.
18.
Zurück zum Zitat Pohlemann T, Gansslen A, Schellwald O, Culemann U, Tscherne H. Outcome after pelvic ring injuries. Injury. 1996;27(suppl 2):B31–B38.PubMed Pohlemann T, Gansslen A, Schellwald O, Culemann U, Tscherne H. Outcome after pelvic ring injuries. Injury. 1996;27(suppl 2):B31–B38.PubMed
19.
Zurück zum Zitat Pohlemann T, Tosounidis G, Bircher M, Giannoudis P, Culemann U. The German Multicentre Pelvis Registry: a template for an European Expert Network? Injury. 2007;38:416–423.PubMedCrossRef Pohlemann T, Tosounidis G, Bircher M, Giannoudis P, Culemann U. The German Multicentre Pelvis Registry: a template for an European Expert Network? Injury. 2007;38:416–423.PubMedCrossRef
20.
Zurück zum Zitat Pohlemann T, Tscherne H, Baumgartel F, Egbers HJ, Euler E, Maurer F, Fell M, Mayr E, Quirini WW, Schlickewei W, Weinberg A. [Pelvic fractures: epidemiology, therapy and long-term outcome: overview of the multicenter study of the Pelvis Study Group] [in German]. Unfallchirurg. 1996;99:160–167.PubMedCrossRef Pohlemann T, Tscherne H, Baumgartel F, Egbers HJ, Euler E, Maurer F, Fell M, Mayr E, Quirini WW, Schlickewei W, Weinberg A. [Pelvic fractures: epidemiology, therapy and long-term outcome: overview of the multicenter study of the Pelvis Study Group] [in German]. Unfallchirurg. 1996;99:160–167.PubMedCrossRef
21.
Zurück zum Zitat Poole GV, Ward EF, Muakkassa FF, Hsu HS, Griswold JA, Rhodes RS. Pelvic fracture from major blunt trauma: outcome is determined by associated injuries. Ann Surg. 1991;213:532–538; discussion 538–539. Poole GV, Ward EF, Muakkassa FF, Hsu HS, Griswold JA, Rhodes RS. Pelvic fracture from major blunt trauma: outcome is determined by associated injuries. Ann Surg. 1991;213:532–538; discussion 538–539.
22.
Zurück zum Zitat Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–343.PubMedCrossRef Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–343.PubMedCrossRef
23.
Zurück zum Zitat Siebert H. [White book of severely injured—care of the DGU: recommendations on structure, organization and provision of hospital equipment for care of severely injured in the Federal Republic of Germany] [in German]. Unfallchirurg. 2006;109:815–820.PubMedCrossRef Siebert H. [White book of severely injured—care of the DGU: recommendations on structure, organization and provision of hospital equipment for care of severely injured in the Federal Republic of Germany] [in German]. Unfallchirurg. 2006;109:815–820.PubMedCrossRef
24.
Zurück zum Zitat Suzuki T, Shindo M, Soma K, Minehara H, Nakamura K, Uchino M, Itoman M. Long-term functional outcome after unstable pelvic ring fracture. J Trauma. 2007;63:884–888.PubMedCrossRef Suzuki T, Shindo M, Soma K, Minehara H, Nakamura K, Uchino M, Itoman M. Long-term functional outcome after unstable pelvic ring fracture. J Trauma. 2007;63:884–888.PubMedCrossRef
25.
Zurück zum Zitat Tile M. Acute pelvic fractures: I. Causation and classification. J Am Acad Orthop Surg. 1996;4:143–151.PubMed Tile M. Acute pelvic fractures: I. Causation and classification. J Am Acad Orthop Surg. 1996;4:143–151.PubMed
26.
Zurück zum Zitat Tosounidis G, Culemann U, Stengel D, Garcia P, Kurowski R, Holstein JH, Pohlemann T. [Complex pelvic trauma in elderly patients] [in German]. Unfallchirurg. 2010;113:281–286.PubMedCrossRef Tosounidis G, Culemann U, Stengel D, Garcia P, Kurowski R, Holstein JH, Pohlemann T. [Complex pelvic trauma in elderly patients] [in German]. Unfallchirurg. 2010;113:281–286.PubMedCrossRef
27.
Zurück zum Zitat Tosounidis G, Holstein JH, Culemann U, Holmenschlager F, Stuby F, Pohlemann T. Changes in epidemiology and treatment of pelvic ring fractures in Germany: an analysis on data of German Pelvic Multicenter Study Groups I and III (DGU/AO). Acta Chir Orthop Traumatol Cech. 2010;77:450–456.PubMed Tosounidis G, Holstein JH, Culemann U, Holmenschlager F, Stuby F, Pohlemann T. Changes in epidemiology and treatment of pelvic ring fractures in Germany: an analysis on data of German Pelvic Multicenter Study Groups I and III (DGU/AO). Acta Chir Orthop Traumatol Cech. 2010;77:450–456.PubMed
28.
Zurück zum Zitat Visser PS, Krosnick JA, Marquette J, Curtin M. Mail surveys for election forecasting? An evaluation of the Colombia Dispatch Poll. Public Opin Q. 1996;60:181–227.CrossRef Visser PS, Krosnick JA, Marquette J, Curtin M. Mail surveys for election forecasting? An evaluation of the Colombia Dispatch Poll. Public Opin Q. 1996;60:181–227.CrossRef
29.
Zurück zum Zitat von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–1457.CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–1457.CrossRef
Metadaten
Titel
What Are Predictors for Patients’ Quality of Life After Pelvic Ring Fractures?
verfasst von
Joerg H. Holstein, MD
Antonius Pizanis, MD
Daniel Köhler, MD
Tim Pohlemann, MD
Working Group Quality of Life After Pelvic Fractures
Publikationsdatum
01.09.2013
Verlag
Springer US
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 9/2013
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-013-2840-y

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