Long-term physical functioning and quality of life after pelvic ring injuries

Abstract

Background Pelvic ring injuries are serious injuries, often associated with substantial morbidity and mortality rates. The long-term consequences of these injuries might affect the patients’ personal life. Our aim was to assess the long-term effects of pelvic ring injuries on physical functioning and quality of life (QoL) using validated patient-reported outcome measures (PROMs) and comparing these results to normative data from the general population. Patients and methods A retrospective cohort study was conducted on adults treated for pelvic ring injuries between 2007 and 2016. Demographics, fracture type, injury mechanism, treatment and complications were recorded. PROMs questionnaires concerning physical functioning (SMFA) and quality of life (EQ-5D) were used. Patients were divided according to their age (18–30, 31–64, 65 and older) and fracture type (Tile/AO type A, B or C). Differences in SMFA and EQ-5D scores of the operatively and non-operatively treated patients and between the study population and general population were analyzed. Results A total of 413 patients were identified of which 279 were eligible for follow-up. One-hundred and ninety-two (69%) patients responded with a mean follow-up of 4.4 years. Patients reported a median score of 13.9 on the SMFA function index, 16.7 on the bother index, 12.5 on the lower extremity, 18.8 on the activities of daily living and 23.4 on the emotion subscale. A median EQ-5D score of 0.8 was reported. There was no difference in physical functioning and QoL between operatively and non-operatively treated patients. Comparison of these results to normative data of the general population revealed a significant ( P < 0.05) decrease in physical functioning and QoL in patients with all types of pelvic ring injuries. Conclusion Long-term physical functioning and QoL in patients who had sustained a pelvic ring injury seems fair, although significantly decreased in comparison with their peers from the general population.

Patient-reported physical functioning and quality of life after pelvic ring injury: A systematic review of the literature

“…Thirty-eight studies [ 8 , 9 , 25 , 26 , 28 – 30 , 32 – 36 , 10 , 37 – 44 , 46 , 47 , 11 , 48 – 54 , 56 , 18 – 22 , 24 ] used a pelvic-specific PROM, either as a single instrument or in combination with a generic PROM. Generic PROMs for physical functioning and quality of life were used in 15 studies [ 8 , 10 , 39 , 40 , 46 , 57 , 58 , 12 , 13 , 15 , 17 , 19 , 23 , 27 , 30 ]. The follow-up moment when these questionnaires were assessed ranged from six months to 15 years after the injury.…”

“…The mean score was 33 (SD 22). The Short Musculoskeletal Function Assessment (SMFA) was used in two studies [ 12 , 13 ]. One study [ 12 ] reported a score of 22 on the function index, 26 on the bother index and 21 on the lower extremity subscale.…”

“…The Short Musculoskeletal Function Assessment (SMFA) was used in two studies [ 12 , 13 ]. One study [ 12 ] reported a score of 22 on the function index, 26 on the bother index and 21 on the lower extremity subscale. The other study [ 13 ] evaluated the scores of the SMFA on three time points (6, 12 and 24 months).…”

“…The scores on the PCS were 37 and 43, and the scores on the MCS 43 and 46. The EQ-5D for the evaluation of quality of life was used in seven studies [ 10 , 12 , 14 , 15 , 17 , 27 , 39 ]. Mean scores ranged from 0.63 to 0.80.…”

An overview of the key principles and guidelines in the management of pelvic fractures

“…Anxiety and depression correlate moderately to strongly with the chronicity stage of this pain (Gerbershagen et al 2010). These patients tend to have a lower quality of life compared to the general population, including a longterm decrease in physical functioning, problems with activities of daily living and adverse psychological health (Banierink et al 2019). Increasing age, complex trauma and surgical management are all predictors of a poor quality of life amongst pelvic fracture patients (Holstein et al 2013).…”