A Ulvik1, R Kvåle, T Wentzel-Larsen, H Flaatten. 1. Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. atle.ulvik@helse-bergen.no
Abstract
BACKGROUND: The aim of the present study was to assess potential long-term reduction in health-related quality of life (HRQOL) in adult trauma patients 2-7 years after discharge from an intensive care unit (ICU), and to study possible determinants of the HRQOL reduction. METHODS: Follow-up study of a cohort of 341 trauma patients admitted to the ICU of a university hospital during 1998-2003. Of the 228 eligible patients, 210 (92%) completed the study. A telephone interview using the EuroQol 5-D (EQ-5D) was conducted. Patients reported their HRQOL both at present and before trauma. RESULTS: Before trauma 88% reported in retrospect no problem in any EQ-5D dimension, compared with 20% at follow-up. After trauma (median 4.0 years) 58% suffered pain/discomfort, 44% reported alterations in usual activities, 40% reduced mobility, 35% anxiety/depression, and 15% limited autonomy. A total of 74% experienced reduction in HRQOL. Severe problems were reported by 16%. Women experienced more anxiety/depression than men. Simplified Acute Physiology Score (SAPS) II and Injury Severity Score (ISS) were significantly associated with impaired HRQOL, while age was not. Patients with severe head injury reported better HRQOL than those without severe head injury. CONCLUSION: More than 2 years post-injury, 74% reported impaired HRQOL but only 16% had severe problems. The majority still suffered pain/discomfort, indicating that pain management is a key factor in improving long-term outcome after severe trauma.
BACKGROUND: The aim of the present study was to assess potential long-term reduction in health-related quality of life (HRQOL) in adult traumapatients 2-7 years after discharge from an intensive care unit (ICU), and to study possible determinants of the HRQOL reduction. METHODS: Follow-up study of a cohort of 341 traumapatients admitted to the ICU of a university hospital during 1998-2003. Of the 228 eligible patients, 210 (92%) completed the study. A telephone interview using the EuroQol 5-D (EQ-5D) was conducted. Patients reported their HRQOL both at present and before trauma. RESULTS: Before trauma 88% reported in retrospect no problem in any EQ-5D dimension, compared with 20% at follow-up. After trauma (median 4.0 years) 58% suffered pain/discomfort, 44% reported alterations in usual activities, 40% reduced mobility, 35% anxiety/depression, and 15% limited autonomy. A total of 74% experienced reduction in HRQOL. Severe problems were reported by 16%. Women experienced more anxiety/depression than men. Simplified Acute Physiology Score (SAPS) II and Injury Severity Score (ISS) were significantly associated with impaired HRQOL, while age was not. Patients with severe head injury reported better HRQOL than those without severe head injury. CONCLUSION: More than 2 years post-injury, 74% reported impaired HRQOL but only 16% had severe problems. The majority still suffered pain/discomfort, indicating that pain management is a key factor in improving long-term outcome after severe trauma.
Authors: Dimitry S Davydow; Douglas F Zatzick; Frederick P Rivara; Gregory J Jurkovich; Jin Wang; Peter P Roy-Byrne; Wayne J Katon; Catherine L Hough; Erin K Kross; Ming-Yu Fan; Jutta Joesch; Ellen J MacKenzie Journal: Gen Hosp Psychiatry Date: 2009-06-23 Impact factor: 3.238
Authors: Steven K Dobscha; Michael E Clark; Benjamin J Morasco; Michele Freeman; Rose Campbell; Mark Helfand Journal: Pain Med Date: 2009-10 Impact factor: 3.750