Paul Andrzejowski1, Patricia Holch2, Peter V Giannoudis3,4. 1. Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds General Infirmary, Clarendon Wing, Floor D, Great George Street, Leeds, LS1 3EX, UK. 2. Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK. 3. NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK. pgiannoudi@aol.com. 4. Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds General Infirmary, Clarendon Wing, Floor D, Great George Street, Leeds, LS1 3EX, UK. pgiannoudi@aol.com.
Abstract
PURPOSE: There is relatively limited large scale, long-term unified evidence to describe how quality of life (QoL) and functional outcomes are affected after polytrauma. The aim of this study is to review validated measures available to assess QoL and functional outcomes and make recommendations on how best to assess patents after major trauma. METHODS: PubMed and EMBASE databases were interrogated to identify suitable patient-reported outcome measures (PROMs) for use in major trauma, and current practice in their use globally. RESULTS: Overall, 81 papers met the criteria for inclusion and evaluation. Data from these were synthesised. A full set of validated PROMs tools were identified for patients with polytrauma, as well as critique of current tools available, allowing us to evaluate practice and recommend specific outcome measures for patients following polytrauma, and system changes needed to embed this in routine practice moving forward. CONCLUSION: To achieve optimal outcomes for patients with polytrauma, we will need to focus on what matters most to them, including their needs (and unmet needs). The use of appropriate PROMs allows evaluation and improvement in the care we can offer. Transformative effects have been noted in cases where they have been used to guide treatment, and if embedded as part of the wider system, it should lead to better overall outcomes. Accordingly, we have made recommendations to this effect. It is time to seize the day, bring these measures even further into our routine practice, and be part of shaping the future.
PURPOSE: There is relatively limited large scale, long-term unified evidence to describe how quality of life (QoL) and functional outcomes are affected after polytrauma. The aim of this study is to review validated measures available to assess QoL and functional outcomes and make recommendations on how best to assess patents after major trauma. METHODS: PubMed and EMBASE databases were interrogated to identify suitable patient-reported outcome measures (PROMs) for use in major trauma, and current practice in their use globally. RESULTS: Overall, 81 papers met the criteria for inclusion and evaluation. Data from these were synthesised. A full set of validated PROMs tools were identified for patients with polytrauma, as well as critique of current tools available, allowing us to evaluate practice and recommend specific outcome measures for patients following polytrauma, and system changes needed to embed this in routine practice moving forward. CONCLUSION: To achieve optimal outcomes for patients with polytrauma, we will need to focus on what matters most to them, including their needs (and unmet needs). The use of appropriate PROMs allows evaluation and improvement in the care we can offer. Transformative effects have been noted in cases where they have been used to guide treatment, and if embedded as part of the wider system, it should lead to better overall outcomes. Accordingly, we have made recommendations to this effect. It is time to seize the day, bring these measures even further into our routine practice, and be part of shaping the future.
Authors: Joseph V Sakran; Hiba Ezzeddine; C William Schwab; Stephanie Bonne; Karen J Brasel; Randall S Burd; Joseph Cuschieri; James Ficke; Barbara A Gaines; Joseph T Giacino; Nicole S Gibran; Adil Haider; Erin C Hall; Juan P Herrera-Escobar; Bellal Joseph; Lillian Kao; Brad G Kurowski; David Livingston; Samuel P Mandell; Deepika Nehra; Babak Sarani; Mark Seamon; Peter Yonclas; Ben Zarzaur; Ronald Stewart; Eileen Bulger; Avery B Nathens Journal: J Am Coll Surg Date: 2020-03-19 Impact factor: 6.113
Authors: Barbara Piškur; Ramon Daniëls; Marian J Jongmans; Marjolijn Ketelaar; Rob J E M Smeets; Meghan Norton; Anna J H M Beurskens Journal: Clin Rehabil Date: 2013-08-29 Impact factor: 3.477
Authors: Michäel Duruisseaux; Anna Martínez-Cardús; Maria E Calleja-Cervantes; Sebastian Moran; Manuel Castro de Moura; Veronica Davalos; David Piñeyro; Montse Sanchez-Cespedes; Nicolas Girard; Marie Brevet; Etienne Giroux-Leprieur; Coraline Dumenil; Monica Pradotto; Paolo Bironzo; Enrica Capelletto; Silvia Novello; Alexis Cortot; Marie-Christine Copin; Niki Karachaliou; Maria Gonzalez-Cao; Sergio Peralta; Luis M Montuenga; Ignacio Gil-Bazo; Iosune Baraibar; Maria D Lozano; Mar Varela; Jose C Ruffinelli; Ramon Palmero; Ernest Nadal; Teresa Moran; Lidia Perez; Immaculada Ramos; Qingyang Xiao; Agustin F Fernandez; Mario F Fraga; Marta Gut; Ivo Gut; Cristina Teixidó; Noelia Vilariño; Aleix Prat; Noemi Reguart; Amparo Benito; Pilar Garrido; Isabel Barragan; Jean-François Emile; Rafael Rosell; Elisabeth Brambilla; Manel Esteller Journal: Lancet Respir Med Date: 2018-08-09 Impact factor: 30.700