The Impact of Major Trauma: Quality-of-Life Outcomes Are Worse in Women than in Men, Independent of Mechanism and Injury Severity

Holbrook, Troy L.; Hoyt, David B.

doi:10.1097/01.ta.0000109758.75406.f8

Cited by 175 publications

(129 citation statements)

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“…A recent study of VA patients found that women and men were comparable on SF-36 component scales [16]. In contrast, a prospective study of patients who had experienced major physical trauma found that women had poorer quality of life outcomes than men, independent of the effects of injury severity and injury characteristics [17].…”

Section: Introductionmentioning

confidence: 99%

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Schnurr

Lunney²

2008

JRRD

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Abstract-Significant gaps exist in our knowledge about gender differences in quality of life among individuals with posttraumatic stress disorder (PTSD). We addressed these gaps by using data from two randomized clinical trials of veterans treated in Department of Veterans Affairs settings: 358 male Vietnam veterans who received group therapy and 203 female veterans who received individual psychotherapy. Using confirmatory factor analysis, we found that a four-factor structure for the Quality of Life Inventory provided the best fit for both groups. Overall quality of life was poor in men and women, and in general, they did not differ in quality of life or in how PTSD was associated with quality of life; the few statistically significant differences were small and clinically insignificant. For both men and women, numbing was uniquely associated with reduced quality of life. We suggest that quality of life should receive increased attention in research and clinical efforts to help veterans with PTSD. Clinical Trial

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Section: Introductionmentioning

confidence: 99%

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Schnurr

Lunney²

2008

JRRD

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“…Also, patients' satisfaction with work status, general health, and recovery from injury are related with impaired mental health, depressive symptoms, and increased risk of substance abuse 30,32 . As a result, the costs of care increases due to patients who needs more medical care, for example longer hospital stay after trauma or multiple hospital visits 25,33,34 .In addition to QOL, PTSD, anxiety, and depression are most frequently examined after injury [26][27][28][29][30][31] . However, information about ASD is scarce.…”

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confidence: 99%

“…Furthermore, pain was found to be a major predictor for psychological adjustment problems two years after injury 16 . ASD, PTSD, and psychological distress are positively associated with wound healing and fatigue 13,[20][21][22][23][24][25] and negatively with quality of life (QOL) compared to the general population 18,[26][27][28][29][30][31] . Also, patients' satisfaction with work status, general health, and recovery from injury are related with impaired mental health, depressive symptoms, and increased risk of substance abuse 30,32 .…”

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confidence: 99%

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Physical Trauma Patients with Symptoms of an Acute and Posttraumatic Stress Disorder: Protocol for an Observational Prospective Cohort Study (Preprint)

Visser¹,

Gosens²,

Oudsten³

et al. 2017

Preprint

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Psychological trauma can be divided into Type-I trauma (i.e. one single traumatic event (e.g. car accident)) and Type-II trauma (i.e. repeated and prolonged traumatization (e.g. abuse)). Physical trauma or injury is a Type-I trauma and a major source of high medical and social costs 1 . In the Netherlands, injury is the leading cause of death for persons younger than 35 years old 2 .Due to registration and implementation of specialized trauma care after injury, the quality of trauma care has been improved and survivorship increased [1][2][3][4][5][6] . However, patients go through a process of treatment after injury: from the ambulance or trauma helicopter to the shock room, possible hospital stay, and finally rehabilitation. The treatment in, for example, the shock room can be impressive and can have a major impact on patients' wellbeing. About 43% to 84% of the patients experience psychological problems (e.g. anxiety, depressive symptoms or opioid abuse) 7-10 and 7% has psychiatric comorbidity after physical trauma 11 . About 25% of the trauma patients have an (subsyndromal) acute stress disorder (ASD) during hospitalization and about 30% had post-traumatic stress disorder (PTSD) one month after injury 12,13 . About 49% showed a delayed onset of PTSD six months after injury. This percentage decreased to 20% at 24 months after injury 13 . Diagnostic criteria for ASD and PTSD are similar with regard to re-experiencing (e.g. flashbacks), increased arousal (e.g. difficulty concentrating), and persistent avoidance (e.g. efforts to avoid thoughts, feelings or places associated with the trauma). However, dissociative symptoms (e.g., numbing, reduction in awareness of surroundings, depersonalization, derealization, and/or dissociative amnesia) are emphasized in ASD, while PTSD does not include dissociative symptoms. Moreover, the diagnosis ASD can only be given within the first month after a traumatic event and last for less than a month. If the symptoms continue longer than a month, a diagnosis of PTSD is given. The symptoms may begin either after trauma or months or years afterwards 14 . PTSD symptoms persist for at least one month after injury 15 .Psychosocial problems and disorders can have a negative impact on patients' lives up to years later 13,[16][17][18] . For instance, 45% of the patients could not pursue with leisure activities and 27% reported a broken marriage six years after trauma 19 . Furthermore, pain was found to be a major predictor for psychological adjustment problems two years after injury 16 . ASD, PTSD, and psychological distress are positively associated with wound healing and fatigue 13,[20][21][22][23][24][25] and negatively with quality of life (QOL) compared to the general population 18,[26][27][28][29][30][31] . Also, patients' satisfaction with work status, general health, and recovery from injury are related with impaired mental health, depressive symptoms, and increased risk of substance abuse 30,32 . As a result, the costs of care increases due to patients who needs more medical care...

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“…Furthermore, many authors are focusing on analyzing differences in outcomes and health-care utilization rates between men and women [7,12]. These efforts should be encouraged and developed.…”

mentioning

confidence: 99%

Gender-specific Issues in Orthopaedic Surgery: Editorial Comment

Rozental

2010

Clinical Orthopaedics &Amp; Related Research

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The Impact of Major Trauma: Quality-of-Life Outcomes Are Worse in Women than in Men, Independent of Mechanism and Injury Severity

Cited by 175 publications

References 42 publications

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Physical Trauma Patients with Symptoms of an Acute and Posttraumatic Stress Disorder: Protocol for an Observational Prospective Cohort Study (Preprint)

Gender-specific Issues in Orthopaedic Surgery: Editorial Comment

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