Assessment of patient-reported outcomes after polytrauma: protocol for a systematic review

Gnass, Irmela; Ritschel, Michaela; Andrich, Silke; Kuske, Silke; Moschinski, Kai; Herrmann‐Frank, Annegret; Metzendorf, Maria‐Inti; Flohé, Sascha; Sturm, J. A.; Windolf, Joachim; Icks, Andrea

doi:10.1136/bmjopen-2017-017571

Cited by 11 publications

(17 citation statements)

References 16 publications

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“…Textwords (tw) and MeSH-terms (mh) like 'polytrauma' (tw), 'multiple trauma' (mh), 'quality of life' (mh), 'activities of daily living' (tw), 'social participation' (mh) and 'pain' (mh) were used. The development of the search strategy was outlined in the study protocol 28 (online supplemental file 2) and is provided in more detail in online supplemental file 3.…”

Section: Methodsmentioning

confidence: 99%

“…More details about the inclusion and exclusion criteria were published in the study protocol. 28 Selection of publications and studies Four teams with two reviewers each (MR-IG; KM-SK; MR-SOB and AI-AHF) screened the title and abstracts independently. To foster the process of eligibility decisions, the inclusion or exclusion of the first 50 publications was discussed by two reviewers (MR-IG).…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

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Assessment of patient-reported outcomes after polytrauma – instruments and methods: a systematic review

et al. 2021

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ObjectivesWe (1) collected instruments that assess health-related quality of life (HRQoL), activities of daily living (ADL) and social participation during follow-up after polytrauma, (2) described their use and (3) investigated other relevant patient-reported outcomes (PROs) assessed in the studies.DesignSystematic Review using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline.Data sourcesMEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, as well as the trials registers ClinicalTrials.gov and WHO ICTRP were searched from January 2005 to April 2018.Eligibility criteriaAll original empirical research published in English or German including PROs of patients aged 18–75 years with an Injury Severity Score≥16 and/or an Abbreviated Injury Scale≥3. Studies with defined injuries or diseases (e.g. low-energy injuries) and some text types (e.g. grey literature and books) were excluded. Systematic reviews and meta-analyses were excluded, but references screened for appropriate studies.Data extraction and synthesisData extraction, narrative content analysis and a critical appraisal (e.g. UK National Institute for Health and Care Excellence) were performed by two reviewers independently.ResultsThe search yielded 3496 hits; 54 publications were included. Predominantly, HRQoL was assessed, with Short Form-36 Health Survey applied most frequently. ADL and (social) participation were rarely assessed. The methods most used were postal surveys and single assessments of PROs, with a follow-up period of one to one and a half years. Other relevant PRO areas reported were function, mental disorders and pain.ConclusionsThere is a large variation in the assessment of PROs after polytrauma, impairing comparability of outcomes. First efforts to standardise the collection of PROs have been initiated, but require further harmonisation between central players. Additional knowledge on rarely reported PRO areas (e.g. (social) participation, social networks) may lead to their consideration in health services provision.PROSPERO registration numberCRD42017060825.

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Section: Methodsmentioning

confidence: 99%

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Assessment of patient-reported outcomes after polytrauma – instruments and methods: a systematic review

et al. 2021

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Section: Data Sources and Search Strategymentioning

confidence: 99%

“…Systematic reviews and meta-analysis were not included, too, but screened to identify further appropriate studies. More details about the inclusion and exclusion criteria were published in the study protocol (27).…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Assessment of Patient-Reported Outcomes After Polytrauma: A Systematic Review

Ritschel

Kuske

Gnass

et al. 2020

Preprint

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Background: Tools assessing patient-reported outcomes (PROs) after polytrauma have not been systematically reviewed so far. Therefore, we sought to: (1) collect instruments that assess health-related quality of life (HRQoL), activities of daily living (ADL), and social participation during follow-up after polytrauma, (2) describe their use (e.g. frequency of application during follow-up), and (3) investigate other relevant PROs assessed in the included studies (e.g. pain, depression, anxiety).Methods: The search was conducted in MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, the trials registers ClinicalTrials.gov, and WHO ICTRP. All original empirical research published between January 2005 and April 2018 was included. Data extraction, narrative content analysis, and a critical appraisal were performed.Results: The search yielded 3496 hits and 54 publications were included in the review. Predominantly, HRQoL was assessed (in 48 of 54 publications), with Short Form-36 Health Survey (SF-36) applied most frequently. ADL and (social) participation were rarely assessed. The follow-up period lasted between 8 days and 17.5 years; assessments were performed between one and five times. Most used were a single assessment of PROs, a follow-up period of 1 to 1.5 years, and a postal survey. Other relevant PRO areas reported were function, mental disorders, and pain.Conclusions: There is a large variation in the assessment of PROs after polytrauma, impairing comparability of outcomes. First efforts to standardise the collection of PROs have been initiated, but further harmonisation between central players, such as trauma registers, is required. Definition and continuous collection of core outcome sets would improve comparability of study results, creating the basis for more targeted treatment. Additional knowledge on rarely reported PRO areas like (social) participation and social network may lead to their consideration in health services provision.Registration: PROSPERO (CRD42017060825)

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“…Within 48 hours after admission, uncontrolled hemorrhage is responsible for more than fifty percent of trauma-related deaths in both military and civilian hospitals [2]. Survivors of major traumas are often faced with long- and short-term burdens even 1 year after suffering the injury, including problems with mobility (34%), self-care (15%) and activities of daily living (ADL) (51%), pain and discomfort (58%) as well as anxiety and depression (37%) [3].…”

Section: Introductionmentioning

confidence: 99%

An Increasing Neutrophil-to-Lymphocyte Ratio Trajectory Predicts Organ Failure in Critically-Ill Male Trauma Patients. An Exploratory Study

et al. 2019

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Background: Although the association of neutrophil proportions with mortality in trauma patients has recently been shown, there is a paucity of research on the association with other outcomes. We sought to investigate the association of neutrophil proportions with organ failure in critically-ill trauma patients. Methods: We reviewed a randomly-selected group of trauma patients admitted to our level-1 trauma intensive care unit between July 2007 and December 2016. Data collected included demographics, injury mechanism and severity (ISS), neutrophil-to-lymphocyte ratio (NLR) at admission and at 24 and 48 hours and organ failure data. NLR patterns during the first 48 hours were divided into two trajectories identified by applying factor and cluster analysis to longitudinal measures. Logistic regression was performed for the association between NLR trajectories and any organ failure; negative binomial regression was used to model the number of organ failures and stage of kidney failure measured by KDIGO classification. Results: 207 patients had NLR data at all three time points. The average age was 44.9 years with mean ISS of 20.6. Patients were 72% male and 23% had penetrating trauma. The 74 patients (36%) with Trajectory 1 had a mean NLR at admission of 3.6, which increased to 14.7 at 48 hours. The 133 (64%) patients in Trajectory 2 had a mean NLR at admission of 8.5 which decreased to 6.6 at 48 hours. Mean NLR was different between the two groups at all three time points (all p < 0.01). There was no significant difference in ISS, age or gender between the two trajectory groups. Models adjusted for age, gender and ISS showed that relative to those with trajectory 2, patients with the trajectory 1 were more likely to have organ failure OR 2.96 (1.42–6.18; p < 0.01), higher number of organ failures IRR 1.50 (1.13–2.00, p < 0.01), and degree of AKI IRR 2.06 (1.04–4.06, p = 0.04). In all cases, the estimated associations were higher among men vs. women, and all were significant among men, but not women. Conclusions: Trauma patients with an increasing NLR trajectory over the first 48 hours had increased risk, number and severity of organ failures. Further research should focus on the mechanisms behind this difference in outcome.

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Assessment of patient-reported outcomes after polytrauma: protocol for a systematic review

Cited by 11 publications

References 16 publications

Assessment of patient-reported outcomes after polytrauma – instruments and methods: a systematic review

Assessment of patient-reported outcomes after polytrauma – instruments and methods: a systematic review

Assessment of Patient-Reported Outcomes After Polytrauma: A Systematic Review

An Increasing Neutrophil-to-Lymphocyte Ratio Trajectory Predicts Organ Failure in Critically-Ill Male Trauma Patients. An Exploratory Study

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