Langzeitergebnisse nach Polytrauma mit ISS ≥ 25

Simmel, Stefan; Drisch, S.; Haag, Sebastian; Bühren, V.

doi:10.1007/s00104-013-2479-y

Cited by 27 publications

(6 citation statements)

References 22 publications

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“…All analyses were adjusted for baseline values of the outcome measures, if available, by including the baseline as a covariate. Adjustments were also made for the background characteristics age, sex and educational level, because after major trauma older age, female gender and low education were reported as being detrimental to long-term QoL [21, 22]. Patients were taken random in the model.…”

Section: Methodsmentioning

confidence: 99%

Effects of an Integrated ‘Fast Track’ Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands

et al. 2017

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ObjectivesThe effects on health related outcomes of a newly-developed rehabilitation program, called ‘supported Fast Track multi-trauma rehabilitation service’ (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual).MethodsProspective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score ≥16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures. The Fast Track program involved: integrated coordination between trauma surgeon and rehabilitation physician, shorter stay in hospital with faster transfer to a specialized trauma rehabilitation unit, earlier start of multidisciplinary treatment and ‘non-weight bearing’ mobilization. Primary outcomes were functional status (FIM) and quality of life (SF-36) measured through questionnaires at baseline, 3, 6, 9 and 12 months post-trauma. Outcomes were analyzed using a linear mixed-effects regression model.ResultsThe FIM scores significantly increased between 0 and 3 months (p<0.001) for both groups showing that they had improved overall, and continued to improve between 3 and 6 months for Fast Track (p = 0.04) and between 3 and 9 months for Care as Usual (p = 0.03). SF-36 scores significantly improved in both groups between 3 and 6 months (Fast Track, p<0.001; Care as Usual, p = 0.01). At 12 months, SF-36 scores were still below (self-reported) baseline measurements of patient health prior to the accident. However, the FIM and SF-36 scores differed little between the groups at any of the measured time points.ConclusionBoth Fast Track and Care as Usual rehabilitation programs were effective in that multi-trauma patients improved their functional status and quality of life. A faster (maximum) recovery in functional status was observed for Fast Track at 6 months compared to 9 months for Care as Usual. At twelve months follow-up no differential effects between treatment conditions were found.Trial RegistrationISRCTN68246661

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Section: Methodsmentioning

confidence: 99%

Effects of an Integrated ‘Fast Track’ Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands

et al. 2017

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“…One reason for this limitation is the rare occurrence of vertebral body fractures without accompanying neurologic symptoms or with concomitant serious injuries to other body regions. Such patients were intentionally excluded from the present study because the evaluation of outcome could be affected by residual neurologic deficits [30] or increasing overall injury severity [43]. Moreover, only patients with fusion of the affected spinal segments were included in the study.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome after dorso-ventral stabilization of the thoracolumbar and lumbar spine with vertebral body replacement and dorsal stabilization

Jäckle,

Assmann,

Roch

et al. 2024

Eur Spine J

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Purpose Surgical stabilization of the spine by vertebral body replacement (VBR) is used for spinal disorders such as traumatic fractures to provide an anatomical re-adjustment of the spine to prevent late detrimental effects and pain [1–4]. This study addresses the clinical outcome after a ventral intervention with VBR and bisegmental fusion. Methods The study includes 76 patients (mean age: 59.34 ± 15.97; 34 females and 42 males) with fractures in the lower thoracic and lumbar spine. They were selected from patients of our hospital who received an anterolateral VBR surgery on the corresponding lower spine region over a nine-year period. Only patients were examined with X-rays and complete follow-up records. Exclusion criteria were changes due to degeneration and pathological fractures. Patients were divided into two groups, the thoracotomy group (Th10-L1) and the lumbotomy group (L2-5), respectively. Minimum one year after surgery, patients were asked about their well-being using a precasted questionnaire. Results No significant differences with respect to the subjective impression of the patients concerning their back pain, spinal functional impairment, their general functional status and their quality of life impairment. Unfortunately, however, only a rather modest but significant increase of the post-surgical life quality was reported. Conclusions Patients who underwent VBR in the lower thoracic or lumbar spine show modest long-term well-being. The results suggest that injuries to the lower thoracic or lumbar spine requiring vertebral body replacement should be classified as severe injuries since they adversely affect the patients’ long-term well-being. Trial registration Study of clinical outcome of patients after vertebral body replacement of the ventral thoracal and lumbal spine, DRKS00031452. Registered 10th March 2023 - Prospectively registered. Trial registration number DRKS00031452.

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“…Die allgemeine Gesundheit, die schon bei Aufnahme in die Rehabilitation als weniger gut oder schlecht eingeschätzt wurde, wirkt bis zum Ende des Beobachtungszeitraumes negativ auf die Lebensqualität. Während höheres Alter den erwarteten negativen Effekt hat, hatte das weibliche Geschlecht in der untersuchten Population einen unerwartet positiven Effekt auf die Lebensqualität [20][21][22]. Gründe hierfür könnten die höhere Teilzeit-Quote von Frauen sein und eine in der Regel geringere Arbeitsschwere, die eine Rückkehr ins Erwerbsleben erleichtern.…”

Section: Diskussionunclassified

Lebensqualität und Arbeitsfähigkeit nach unfallchirurgischer Rehabilitation – Ergebnisse der icfPROreha-Studie

Simmel

Kus

Oberhauser

et al. 2023

Rehabilitation (Stuttg)

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Zusammenfassung Hintergrund Nicht nur die Schwere der Verletzung, sondern auch bio-psycho-soziale Faktoren haben einen Einfluss auf gesundheitsbezogene Lebensqualität und soziale Teilhabe nach schweren muskuloskelettalen Verletzungen. Methode Multizentrische prospektive Längsschnittstudie mit Nacherhebungszeitraum bis zu 78 Wochen nach Entlassung aus der stationären unfallchirurgisch-orthopädischen Rehabilitation bei Patienten mit schweren muskuloskelettalen Verletzungen. Die Datenerfassung erfolgte mittels eines umfassenden Assessment-Tools. Lebensqualität wurde mit dem EQ-5D-5L erfasst, die Arbeitsfähigkeit mittels Selbstangaben der Patienten und einer Abfrage bei Kostenträgern. Analysen zum Zusammenhang zwischen Lebensqualität und Arbeitsfähigkeit, zur Veränderung der Lebensqualität im Verlauf im Vergleich zur deutschen Allgemeinbevölkerung und multivariate Analysen zur Prädiktion der Lebensqualität wurden durchgeführt. Ergebnis Von 612 Studienteilnehmern (444 Männer (72,5%); M=48,5 Jahre; SD 12,0) kehrten 78 Wochen nach Entlassung aus der stationären Rehabilitation 502 (82,0%) an den Arbeitsplatz zurück. Die Lebensqualität verbessert sich im Verlauf der Rehabilitationsmaßnahme im Mittel deutlich von 50,18 auf 64,50 (visuelle Analogskala des EQ-5D-5L) und im weiteren Verlauf geringfügig auf 69,38 zu 78 Wochen nach Entlassung aus der stationären Rehabilitation. Der EQ-5D Index liegt unter den Normwerten der Allgemeinbevölkerung. 18 Aspekte zur Prädiktion der Lebensqualität 78 Wochen nach Entlassung aus der Rehabilitation wurden selektiert. Unter anderem haben Ruheschmerz und der Verdacht auf eine Angststörung bei Aufnahme einen sehr starken Effekt auf die Lebensqualität. Auch Kontextfaktoren wie Therapien nach der Akutversorgung und Selbstwirksamkeit haben einen Effekt auf die Lebensqualität 78 Wochen nach Entlassung aus der stationären Rehabilitation. Schlussfolgerung Bio-psycho-soziale Faktoren haben einen großen Einfluss auf die langfristige Lebensqualität Unfallverletzter. Bereits bei der Entlassung aus der Akutklinik und mehr noch zu Beginn der stationären Rehabilitation können entscheidende Weichen gestellt werden, um eine bestmögliche Lebensqualität für die Betroffenen zu erreichen.

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Langzeitergebnisse nach Polytrauma mit ISS ≥ 25

Cited by 27 publications

References 22 publications

Effects of an Integrated ‘Fast Track’ Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands

Effects of an Integrated ‘Fast Track’ Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands

Clinical outcome after dorso-ventral stabilization of the thoracolumbar and lumbar spine with vertebral body replacement and dorsal stabilization

Lebensqualität und Arbeitsfähigkeit nach unfallchirurgischer Rehabilitation – Ergebnisse der icfPROreha-Studie

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