Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Outcome and quality of life 5 years after major trauma.
Department of Surgical Science, Karolinska Institute.ORCID iD: 0000-0002-9273-9448
2005 (English)In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 59, no 1, 223-232 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: This study aimed to determine quality of life after injury and identify factors potentially associated with outcome.

METHODS: Five years after injury from blunt or penetrating trauma, patients received a questionnaire based on the SF-36 Health Survey.

RESULTS: Two hundred five patients (83%) replied. Most were men, median age 39 years, 93% injured by blunt energy, median Injury Severity Score 14 (range 9-57). Mean SF-36 scores were significantly lower than in a matched reference group. Poor outcome was associated with: in-hospital days, intensive care days, surgical procedures, in-hospital major complications, age, recurrent injury, and inadequate information. Subjects reported considerable physical (68%) and psychologic (41%) disabilities. Near half reported need of improved follow-up care. Injury severity did not predict poor health-related quality of life 5 years later.

CONCLUSION: Adequate information, sufficient pain management and follow-up by trauma specialist teams are needed. Certain factors can help identify patients in need of additional help and support.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2005. Vol. 59, no 1, 223-232 p.
Keyword [en]
quality of life, trauma
National Category
Nursing
Identifiers
URN: urn:nbn:se:rkh:diva-505DOI: 10.1097/01.TA.0000173832.01547.CBPubMedID: 16096568OAI: oai:DiVA.org:rkh-505DiVA: diva2:606659
Available from: 2013-02-20 Created: 2013-02-20 Last updated: 2015-10-14Bibliographically approved
In thesis
1. Adult and pediatric trauma: outcomes and health-related quality of life
Open this publication in new window or tab >>Adult and pediatric trauma: outcomes and health-related quality of life
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Trauma is the number one killer of children and young adults and the  most common cause for hospital admissions for these age-groups in Sweden. Trauma is  also one of the most common causes for hospital care and early death for older people.  In the last decades trauma care has advanced and improved short-term survival of  injured but knowledge of the long-term outcome is limited.

The overall aim of this thesis is to investigate long-term outcome and health-related  quality of life after injuries in different age groups and to identify factors associated  with outcome.

Methods: The thesis is based on four studies. In the first study patients with major  trauma were contacted 5 years after injury and HRQL was measures using the SF-36  questionnaire and compared to an age and sex-matched reference group. In the second  study data was collected on children with injuries to describe demographic and injury  characteristics and outcome. The sample in the second study was the source for the  third and fourth study. The third study measured HRQL using the PedsQL 4.0 in a  cohort of children 6 years after injury and determined the relationship within subgroups  in the cohort. The fourth study measured child HRQL in a sample of children after  injury and their parent´s and determined the relationship within scoring results and the impact of parents reported mental health status.

Results: The adult major trauma patients (n=205) reported significantly lower HRQL  scores in all eight domains compared to the reference group. A large number of patients  suffered from physical (68%) and psychological disabilities (41%) and nearly half reported the need for better follow-up after discharge from hospital. The severity of the injury did not anticipate a lower health-related quality of life. In the pediatric group  (n=432) the median injury severity score was 4 (IQR 1-9), 50% sustained head injuries  and the most severe head injuries were seen in the youngest age group. Mortality rate  was low (1%), 19% stayed in a PICU and the median length of hospital stay was two  days. In the follow-up study (n=204) the youngest children had the lowest PedsQL  scores. Children who suffered from extremity injuries had lower scores in the school  functioning compared to children with head injuries. The levels of agreement between  child self-report and parent proxy report of PedsQL 4.0 scales were excellent  (ICC≥0.80) for all scales with the exception of children´s self-reported emotional  functioning. Multiple regression analyses showed that poor parental mental health  status contributed to worse child self-report and parent proxy report of children´s  HRQL.

Conclusion: Adult major trauma patients have significant disabilities 5 years after  injury. Improved follow-up by trauma specialist teams are needed. Children´s HRQL 6  years after trauma seems to in parity or better than healthy peers. Parent´s mental health  status can possibly impact on children´s HRQL long after an injury. Further studies are  recommended to evaluate the PedsQL 4.0versions for self-report in pediatric trauma  population.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2012. 76 p.
Keyword
Trauma, Injury, Health- related quality of life, Follow- up, Pediatric, Adolescents, SF-36, PedsQL 4, 0
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-844 (URN)978-91-7457-954-3 (ISBN)
Public defence
2012-12-07, Henry Dunant, Teknikringen 1, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Submitted (title: Health-related quality of life of children and adolescents 6 years after pediatric trauma). Paper 4: Manuscript (title: Health-related quality of life 6 years after pediatric trauma: Impact of parental mental health on child-parent reports).

Available from: 2014-06-11 Created: 2014-06-10 Last updated: 2015-10-14Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Sluys, Kerstin
In the same journal
Journal of Trauma
Nursing

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 228 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf