Predicting health status in the first year after trauma

Munter, Leonie de; Polinder, Suzanne; Ree, Cornelis L. P. van de; Kruithof, Nena; Lansink, Koen W.W.; Jongh, Mariska A. C. de

doi:10.1002/bjs.11132

Cited by 22 publications

(21 citation statements)

References 30 publications

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“…Different results were found for Conscientiousness and Agreeableness. Surprisingly, except for high education in environment trajectory, no sociodemographic (e.g., female sex) and clinical characteristics were found as risk factors for impaired QOL, which is contrary with earlier research [12,15,17,18].…”

Section: Discussioncontrasting

confidence: 99%

“…These disabilities and disorders were, together with sociodemographic (e.g., older age, female sex, low education) and clinical (e.g., higher injury severity score, hospital stay and ICU admission) characteristics, related to impaired health-related QOL (HRQOL) or health status (HS) [9,12,[14][15][16][17][18]. HRQOL is a limited definition of QOL, as it solely focuses on patients' subjective perceptions on health (i.e., physical and mental health), whereas HS refers to the extent of physical, psychological, and social functioning, but without taken patients' satisfaction with functioning into account [19].…”

Section: Introductionmentioning

confidence: 99%

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Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

et al. 2021

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Background The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach. Methods Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient. Results Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness. Discussion Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

et al. 2021

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“…It is becoming increasingly important to formally assess elderly patients for challenges to their functional status due to frailty 9–11 . Frailty is a measure of increased vulnerability and decreased physiological reserve to stressors, such as surgery, which impairs recovery and return to preoperative functional level 12,13 . It affects as many as 20 per cent of elderly patients, and may be associated with mortality, postoperative complications and longer hospital stay after surgery 4–7,14–16 .…”

Section: Introductionmentioning

confidence: 99%

Frailty in older patients undergoing emergency colorectal surgery: USA National Surgical Quality Improvement Program analysis

Simon

Paula

Luz

et al. 2020

British Journal of Surgery

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Background Frailty is associated with advancing age and may result in adverse postoperative outcomes. A suspected growing elderly population needing emergency colorectal surgery stimulated this study of the prevalence and impact of frailty. Methods Elderly patients (defined as aged at least 65 years by Medicare and the United States Census Bureau) who underwent emergency colorectal resection between 2012 and 2016 were identified from the American College of Surgeons National Surgical Quality Improvement Program population database. The five‐item modified frailty index (mFI‐5) score was calculated, and patients stratified into groups 0, 1 or 2 + . Main outcome measures were the prevalence of frailty, and its impact on 30‐day postoperative morbidity, mortality, reoperation, duration of hospital stay (LOS), discharge destination and readmission. Results A total of 10 025 patients were identified with a median age 75 years, of whom 41·8 per cent were men. The majority (87·7 per cent) had an ASA fitness grade of III or greater and 3129 (31·2 per cent) were frail (mFI‐5 group 2+). Major morbidity occurred in one‐third of patients and the postoperative mortality rate was 15·9 per cent. Some 52·0 per cent of patients had a prolonged hospital stay and 11·0 per cent were readmitted. Although most patients (88·0 per cent) lived independently before surgery, only 45·4 per cent were discharged home directly. Frailty (mFI‐5 2+) predicted mortality, overall and major morbidity, reoperation, prolonged LOS, discharge to an institution and readmission, but frailty was independent of sex. Conclusion Frailty is associated with morbidity, mortality and loss of independence in elderly patients needing emergency colorectal surgery.

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“…Although some studies examined the prognostic factors for a lower health status in severely injured patients little is known about the differences between short-and long-term prognostic factors. De Munter et al (2019) [26] showed that pre-injury status is an important predictor of health status in the whole trauma population. However, it is unknown if these predictors are equal in the group of severely injured patients.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal analysis of health status the first year after trauma in severely injured patients

Havermans¹,

Jongh²,

Munter

et al. 2020

Scand J Trauma Resusc Emerg Med

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Purpose: While survival rates after a trauma are increasing a considerable part of the trauma population are still at risk for both short and long term disabilities. Little is known about prognostic factors over time after a severe trauma. The aim of the present prospective cohort study was to examine trauma and patient related prognostic factors for a lower health status over time after a severe trauma. Methods: A multicentre prospective observational cohort study was conducted. Adult trauma patients with severe injuries (ISS ≥ 16) were included from August 2015 until November 2016 if admitted to one of the hospitals in Noord-Brabant (the Netherlands). Outcome measure was health status, measured by the EuroQol-5D (EQ-5D utility and EQ-Visual analogue scale) and the Health Utilities Index (HUI2 and HUI3) one week and one, three, six, and twelve months after injury. Patient and trauma characteristics were analysed as prognostic factors with linear mixed models. The effect of each prognostic factor over time was analysed by adding the interaction term between the prognostic factor and time point in a multivariable linear mixed model, adjusted for confounders. Additionally, the risk factors for problems in the EQ-5 dimensions of HS and cognition were analysed. Results: In total 239 severely injured patients participated. Pre-injury health status, hospital length of stay, ISS and comorbidities were significant prognostic factors for a lower health status. A younger age and extremity injury were prognostic factors for a lower health status until one month after trauma and unemployment before trauma and comorbidities six until twelve months after trauma. In the EQ-5 dimensions 44.1% remained problems in mobility, 15.3% in self-care, 46.4% in activity, 53.3% in pain, 32.5% in anxiety and 35.7% in cognition. Conclusions: Lower pre-injury health status, longer hospital length of stay, higher ISS, and comorbidities were significant prognostic factors for a lower health status during one year after a severe injury. A younger age and an extremity injury were short-term prognostic factors and unemployment before trauma and comorbidities were long-term prognostic factors. Even after twelve months patients in our population reported more problems in all EQ-5D dimensions when compared to the Dutch reference population.

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Predicting health status in the first year after trauma

Cited by 22 publications

References 30 publications

Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

Frailty in older patients undergoing emergency colorectal surgery: USA National Surgical Quality Improvement Program analysis

Longitudinal analysis of health status the first year after trauma in severely injured patients

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