Assessment of pre-injury health-related quality of life: a systematic review

Scholten, Annemieke C.; Haagsma, Juanita A.; Beeck, Ed F. van; Polinder, Suzanne

doi:10.1186/s12963-017-0127-3

Cited by 53 publications

(47 citation statements)

References 56 publications

(324 reference statements)

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“…It is a common occurrence that injury victims report pre-injury HR-QoL that exceeds age-speci c population norms (30). In our study, this was, however, only apparent in patients with negative BAL, whereas in patients with positive BAL we noticed the opposite.…”

Section: Discussioncontrasting

confidence: 66%

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

Riuttanen

Jokihaara²,

Huttunen³

et al. 2020

Preprint

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Background From one third up to half of all injured patients admitted to emergency rooms have a positive blood alcohol level (BAL). Frequent alcohol use also has negative effects on a person’s quality of life. Even though alcohol use among injury patients is common, the effects of pre-injury alcohol use on Health-Related Quality of Life (HR-QoL) have not previously been studied. The primary objective of this study was to evaluate whether pre-injury alcohol use has an influence on an injured patient’s HR-QoL and reported problems. A secondary objective was to compare injured patient’s HR-QoL with the population norm of Finland. Methods Retrospective analysis of all trauma patients treated at Tampere University Hospital’s (TAUH) Intensive Care Unit (ICU) or High Dependence Unit (HDU) in 2013. The following inclusion criteria were used: patient treated at TAUH’s ICU or HDU, age ≥ 18 years, NISS ≥ 16 and possesses a valid Finnish personal identification number to enable comprehensive follow-up. From a total of 373 patients, 227 patients met the inclusion criteria. HR-QoL was assessed with the EQ-5D questionnaire during the patients’ stay in the ICU/HDU and one year after the injury. The EQ-5D index value was further compared with the index values of the age-matched population norms of Finland. Results Thirty-four percent (77/227) of all patients tested positive for alcohol at the time of the injury with a mean blood alcohol content (BAC) of 1.9 g/L. Twenty-nine patients (N= 29/227) died within 1 year of injury, and therefore 198 patients were contacted for post-injury EQ-5D questionnaires. Complete data sets with both pre- and post-injury EQ-5D questionnaires were available for 111 (56%) patients. Patients with positive BAL expressed notably more anxiety and depression (45%) before trauma compared to both patients with negative BAL (11%) and the reference population of Finland (14%). Overall, pre-injury HR-QoL was also poorer in BAL positive patients than BAL negative patients. The amount of anxiety and depression in BAL positive patients decreased after injury. In both groups, the relative number of reported problems after injury exceeded the relative number of reported problems of the reference population of Finland in all five EQ-5D dimensions. Conclusions Patients with positive BAL upon admission report overall lower HR-QoL than patients with negative BAL. This finding is most likely explained by the excessive amount of anxiety and depression, which had decreased one year after injury. We speculate that this may partly be explained by a possible reduction in alcohol use, which has been reported to happen in injury patients. As has previously been reported, the impact of severe injury on post-injury QoL in general is detrimental and long-lasting and overall HR-QoL remains lower than the population norm.

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Section: Discussioncontrasting

confidence: 66%

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

Riuttanen

Jokihaara²,

Huttunen³

et al. 2020

Preprint

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“…One limitation of the study stems from the impossibility of obtaining information prospectively on the prefracture situation, and therefore assuming the possibility of memory bias and underestimation of the results [47]. HRQoL in patients after hip fracture may be influenced by other unrelated factors such as pre-existing comorbidities [48].…”

Section: Discussionmentioning

confidence: 99%

Quality of life in elderly people after a hip fracture: a prospective study

Amarilla-Donoso¹,

López-Espuela

Roncero-Martín

et al. 2020

Health Qual Life Outcomes

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Background: Hip fracture is an important social and medical problem due to its increasing prevalence, the consequences for health and the economic impact on the health care system, but there is no doubt that it also has repercussions on health-related quality of life (HRQoL). Hence the importance of understanding and determining the impact of the condition on everyday life from the perspective of the patient's physical, emotional and social well-being. Purpose: To determine the impact of hip fracture on HRQoL of people over the age of 65 1 month after surgery, related factors and the effects on functional ability and mood. Methods: Prospective observational study conducted in the traumatology units of two university hospitals in the province of Cáceres with consecutive sampling of all patients over the age of 65 admitted for hip fracture surgery during the study period. Sociodemographic and clinical data were recorded at the time of admission and prospectively at the follow-up visit 1 month later. Clinical, social, quality of life (EQ-5D-), basic functional and instrumental capacity (Barthel Index (BI) and Lawton & Brody Scale), and geriatric depression (Yesavage) variables were collected. Results: The study included 224 patients with a median age of 84.6 years (SD ± 6.1), 76.3% were female. Charlson's comorbidity was 5.3 (SD ± 1.2). The EQ-5D index decreased from 0.62 (SD ± 0.35) to 0.16 at 1 month follow up (SD ± 0.20) p < 0.001. The mean Visual Analog Scale (VAS) score of EQ-5D decreased from 72.8 (SD ±15.8) to 48.3 (SD ± 17.2) p < 0.001. All dimensions of EQ-5D showed a significant reduction from the time of pre-fracture status to 1 month after surgery. Independent factors associated with HRQoL 1 month after surgery were pre-fracture status Barthel Index score, Lawton and Brody scale, presence of depression, and type of surgery. Conclusions: After a hip fracture, patients experience considerable deterioration in their HRQoL, especially in selfcare, daily activities, and mobility. There is also a significant decline in functional capacity for both the basic and instrumental activities of daily living. One month after surgery, HRQoL is a long way from pre-fracture levels.

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“…This is because individuals from the general population are unlikely to be representative of those from an injured population [68]. A systematic review of studies collecting pre-injury HRQL data among injury patients has demonstrated that both general population comparisons and retrospective assessments are likely to result in biased estimates of preinjury HRQL [69]. However, prospective HRQL data is often impractical to collect prior to an injury occurring.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of studies measuring health-related quality of life of general injury populations: update 2010–2018

Geraerds

Richardson

Haagsma

et al. 2020

Health Qual Life Outcomes

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Background: Studies examining the impact of injury on health-related quality of life (HRQL) over time are necessary to understand the short-and long-term consequences of injury for population health. The aim of this systematic review was to provide an evidence update on studies that have measured HRQL over time in general injury populations using a generic (general) health state measure. Methods: Studies conducted between 2010 and 2018 that assessed HRQL at more than one time point among general injury populations were eligible for inclusion. Two reviewers independently extracted information from each study on design, HRQL measure used, method of HRQL measure administration, timing of assessment(s), predictive variables, ability to detect change, and findings. Quality appraisals of each study were also completed by two reviewers using items from the RTI Item Bank on Risk of Bias and Precision of Observational Studies and the Guidelines for the Conduction of Follow-up Studies Measuring Injury-Related Disability. Results: Twenty-nine studies (44 articles) that met the inclusion criteria were identified. HRQL was measured using 14 different generic measures; the SF-36, SF-12, and EQ-5D were used most frequently. A varying number of follow-up assessments were undertaken, ranging from one to five. Follow-up often occurred 12 months post-injury. Fewer studies (n = 11) examined outcomes two or more years post-injury, and only one to 10 years post-injury. While most studies documented improvements in HRQL over time since the injury event, study populations had not returned to pre-injury status or reached general population norm HRQL values at post-injury follow-ups. Conclusions: Since 2010 there has been a substantial increase in the number of studies evaluating the HRQL of general injury populations. However, significant variability in study design continues to impede quantification of the impact of injury on population health over time. Variation between studies is particularly evident with respect to timing and number of follow-up assessments, and selection of instruments to evaluate HRQL.

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Assessment of pre-injury health-related quality of life: a systematic review

Cited by 53 publications

References 56 publications

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

Quality of life in elderly people after a hip fracture: a prospective study

A systematic review of studies measuring health-related quality of life of general injury populations: update 2010–2018

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