Health-related quality of life and return to work 1 year after major trauma from a network perspective

Ditshuizen, Jan C. van; Lieshout, Esther M.M. Van; Beeck, Ed F. van; Verhofstad, M.H.J.; Hartog, Dennis den

doi:10.1007/s00068-021-01781-2

Cited by 9 publications

(17 citation statements)

References 34 publications

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“…HRQoL of patients suffering severe trauma was below population norms [40,53,57,64,76,88,97,167,171,176,178,185,191,194,198] and lower than pre-injury HRQoL [44,47,55,56,185,186,[192][193][194] in most studies. Furthermore, patients with an ISS ≥ 16 reported a lower HRQoL than did patients with an ISS < 16 [53,55].…”

Section: Eq-5dmentioning

confidence: 80%

Health-related quality of life after severe trauma and available PROMS: an updated review (part I)

Lotfalla

Halm

Schepers

et al. 2022

Eur J Trauma Emerg Surg

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Introduction Throughout the years, a decreasing trend in mortality rate has been demonstrated in patients suffering severe trauma. This increases the relevance of documentation of other outcomes for this population, including patient-reported outcome measures (PROMs), such as health-related quality of life (HRQoL). The aim of this review was to summarize the results of the studies that have been conducted regarding HRQoL in severely injured patients (as defined by the articles’ authors). Also, we present the instruments that are used most frequently to assess HRQoL in patients suffering severe trauma. Methods A literature search was conducted in the Cochrane Library, EMBASE, PubMed, and Web of Science for articles published from inception until the 1st of January 2022. Reference lists of included articles were reviewed as well. Studies were considered eligible when a population of patients with major, multiple or severe injury and/or polytrauma was included, well-defined by means of an ISS-threshold, and the outcome of interest was described in terms of (HR)QoL. A narrative design was chosen for this review. Results The search strategy identified 1583 articles, which were reduced to 113 after application of the eligibility criteria. In total, nineteen instruments were used to assess HRQoL. The SF-36 was used most frequently, followed by the EQ-5D and SF-12. HRQoL in patients with severe trauma was often compared to normative population norms or pre-injury status, and was found to be reduced in both cases, regardless of the tool used to assess this outcome. Some studies demonstrated higher scoring of the patients over time, suggesting improved HRQoL after considerable time after severe trauma. Conclusion HRQoL in severely injured patients is overall reduced, regardless of the instrument used to assess it. The instruments that were used most frequently to assess HRQoL were the SF-36 and EQ-5D. Future research is needed to shed light on the consequences of the reduced HRQoL in this population. We recommend routine assessment and documentation of HRQoL in severely injured patients.

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Section: Eq-5dmentioning

confidence: 80%

Health-related quality of life after severe trauma and available PROMS: an updated review (part I)

Lotfalla

Halm

Schepers

et al. 2022

Eur J Trauma Emerg Surg

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“… Work : Reduced HRQoL was associated with reduced capacity to work [ 54 ] and vice versa did unemployment, inability to work, and having to deal with financial loss due to trauma predict a poorer HRQoL [ 32 , 35 , 41 , 42 , 86 , 144 , 158 ]. The capacity to return to work impacted HRQoL positively, and improved HRQoL helped patients return to work [ 155 ]. Employed patients were less likely to report poor HRQoL compared to unemployed patients at the time of injury [ 35 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…A greater BMI was associated with more severe pain in the long term [ 54 ] (see Table 1, Supplementary Appendix B). Comorbidity : Significantly lower HRQoL scores were found in patients with pre-injury comorbidity (not further specified) [ 31 , 36 , 41 , 55 , 138 – 140 , 155 , 158 ]. Pain medication was significantly less used in patients without pre-existing comorbidities [ 149 ].…”

Section: Resultsmentioning

confidence: 99%

“… Body region of injury : 47 publications [ 2 , 29 – 31 , 34 – 39 , 42 – 44 , 46 , 48 , 53 – 55 , 60 , 63 – 76 , 86 , 130 – 133 , 136 , 140 – 143 , 149 , 155 , 156 , 159 ] reported on the influence of the location of injury on the HRQoL. Injury to the extremities was an important predictor for poor HRQoL [ 29 – 31 , 35 , 39 , 42 , 44 , 70 , 72 – 76 , 131 , 132 , 142 , 143 , 149 , 155 , 156 ], with multiple extremity injuries predicting worse HRQoL, greater disability, and lower return rates to productivity on the long term [ 132 ]. Worse physical functioning was reported in patients suffering from lower extremity injury compared to upper-extremity injury [ 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…Upper extremity injury was also found to be a predictor for worse HRQoL, more disability, and reduced return to work in some studies [ 31 , 142 , 156 ], especially when the brachial plexus was injured [ 71 ]. Although some studies ( n = 10) indicated no (significant) correlation between (the severity of) head and/or neurological injuries and HRQoL [ 29 , 38 , 46 , 48 , 63 , 65 , 67 , 86 , 138 , 142 ], the majority (n = 16) of publications did [ 31 , 36 , 37 , 42 , 43 , 48 , 54 , 55 , 60 , 64 , 66 , 68 , 69 , 74 , 136 , 155 ]; especially mental and cognitive function were affected as well as the pain domain [ 36 , 43 , 48 , 54 , 55 , 64 , 66 , 69 , 156 ], with an initial lower Glasgow Coma Scale (GCS) predicting worse HRQoL [ 60 , 68 , 69 ]. GCS appeared to be a reliable predictor of HRQoL in some populations [ 60 , 68 ], and was negatively associated with self-reported physical health.…”

Section: Resultsmentioning

confidence: 99%

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Parameters influencing health-related quality of life after severe trauma: a systematic review (part II)

Lotfalla

Halm

Schepers

et al. 2023

Eur J Trauma Emerg Surg

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Introduction It is increasingly recognized that health-related quality of life (HRQoL) is a relevant outcome to study in populations comprising severely injured patients. Although some studies have readily demonstrated a compromised HRQoL in those patients, evidence regarding factors that predict HRQoL is scarce. This hinders attempts to prepare patient-specific plans that may aid in revalidation and improved life satisfaction. In this review, we present identified predictors of HRQoL in patients that have suffered severe trauma. Methods The search strategy included a database search until the 1st of January 2022 in the Cochrane Library, EMBASE, PubMed, and Web of Science, and reference checking. Studies were eligible for inclusion when (HR)QoL was studied in patients with major, multiple, or severe injury and/or polytrauma, as defined by authors by means of an Injury Severity Score (ISS) cut-off value. The results will be discussed in a narrative manner. Results A total of 1583 articles were reviewed. Of those, 90 were included and used for analysis. In total, 23 possible predictors were identified. The following parameters predicted reduced HRQoL in severely injured patients and came forward in at least more than three studies: higher age, female gender, lower extremity injuries, higher rate of injury severity, lower achieved educational level, presence of (pre-existing) comorbidities and mental illness, longer duration of hospital stay, and high level of disability. Conclusion Age, gender, injured body region, and severity of injury were found to be good predictors of health-related quality of life in severely injured patients. A patient-centered approach, based on individual, demographic, and disease-specific predictors, is highly recommended.

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Unemployment and Personal Income Loss After Traumatic Brain Injury

Malhotra,

Jaffe,

Shakil

et al. 2024

JAMA Surg

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ImportanceEmployment and personal income loss after traumatic brain injury is a major source of postinjury stress and a barrier to societal reintegration. The magnitude of labor market ramifications following traumatic brain injury remains largely unknown.ObjectivesTo quantify the 3-year postinjury labor market consequences following traumatic brain injury in Canada. To also estimate the incurred national labor market cost over the study period.Design, Setting, and ParticipantsThis retrospective quasi-experimental, pan-Canadian observational cohort study used linked administrative health and federal taxation data obtained between 2007 and 2017. Mixed-effects difference-in-difference regressions were constructed to estimate the annualized magnitude of the personal income and employment loss during each of the 3 years following injury, respectively, relative to preinjury baseline. Participants included tax-filing adult (19 to 61 years old) traumatic brain injury survivors.ExposureTraumatic brain injury.Main Outcome MeasuresCoprimary outcomes were personal income loss and the proportion of newly unemployed individuals per annum. Secondary objectives were to quantify income and employment loss within mild, moderate, and severe traumatic brain injury subgroups.ResultsA total of 18 050 patients with traumatic brain injury between 2007 and 2017 were identified (mean age, 38.0 [SD, 12.4] years; 13 360 male [74.0%]), each of whom was followed up with for 3 consecutive fiscal years. Mean income was CAD $42 600 (US $31 083) in the fiscal year prior to injury and 82% were employed at time of injury. The adjusted mean loss of personal income was CAD $7635 (US $5650) in the first year after injury (Y+1) and CAD $5000 (US $3700) in the third year after injury (Y+3) relative to uninjured controls. In each of the 3 postinjury years, 7.8% individuals were newly unemployed compared with the preinjury baseline. The adjusted average personal income loss for mild, moderate, and severe traumatic brain injury subgroups were CAD $3354 (US $2482), CAD $6750 (US $4995), and CAD $17 375 (US $12 859), respectively, at Y+3; the proportion of unemployed individuals increased by 5.8%, 9.2%, and 20% across the same groups at Y+3 after injury relative to preinjury baseline. The estimated total reduction in personal income aggregated over the 3 postinjury years for the affected participants was CAD $588 million (US $435 million).Conclusions and RelevanceThis work represents national cohort data quantifying the labor market implications of traumatic brain injury. These results may be used to inform economic evaluations and social service resource allocation.

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Health-related quality of life and return to work 1 year after major trauma from a network perspective

Cited by 9 publications

References 34 publications

Health-related quality of life after severe trauma and available PROMS: an updated review (part I)

Health-related quality of life after severe trauma and available PROMS: an updated review (part I)

Parameters influencing health-related quality of life after severe trauma: a systematic review (part II)

Unemployment and Personal Income Loss After Traumatic Brain Injury

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