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Quality of life after multiple trauma: results from a patient cohort treated in a certified trauma network

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Besides mortality, the patient-reported outcome (PRO) in survivors of multiple trauma is of increasing interest. So far, no data on patient-reported outcome measures (PROMs) after multiple trauma from an entire trauma network are available. Within this study, the course of the PRO over time and differences between level I and level II trauma centers within an entire trauma network was evaluated.

Methods

Multiple injured patients, treated in a rural trauma network over 2 years, were prospectively included in this study. After 6, 12 and 24 months the results of the European Quality of Life (EuroQoL) EQ-5D outcome instrument were evaluated. To adjust for differences in trauma severity between level I and level II centers, the Revised Injury Severity Classification II (RISC II) and the Functional Capacity Index (FCI) were used to adjust the life-quality results of patients.

Results

501 patients were included, 118 patients with an ISS < 16 points, 383 patients reached 16 points or more. Despite a steady increase of EQ-5D index over time (6 months: 0.71 ± 0.31; 12 months: 0.74 ± 0.28; 24 months: 0.76 ± 0.27; p < 0.001), the values of a reference population could not be reached even 2 years after trauma (EQ-5D reference population: 0.9). After adjustment for trauma severity, no significant differences in PROMs between level I and level II centers could be detected (p = 0.188).

Conclusion

The consistently low EQ-5D index relative the reference population and the lack of a difference between level I and II centers suggest that improved strategies for polytrauma aftercare are called for.

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Acknowledgements

The project is funded by a grant from the German Federal Ministry of Education and Research (reference number 01GY1153) in the context of the funding initiative Health Services Research. On behalf of the Trauma Network Eastern Bavaria (TNO): Klinikum Amberg, Dr. Bauer; Krankenhaus Bogen, Dr. Lehner; Krankenhaus Burglengenfeld, Dr. Cedl; Krankenhaus Cham, Dr. Walter; Klinikum Deggendorf, Prof. Schandelmaier; Krankenhaus Dingolfing, Dr. Maurer; Krankenhaus Eggenfelden, Prof. Wick; Krankenhaus Freyung, Dr. Barz; Krankenhaus Kelheim, Dr. Obermeier; Krankenhaus Landshut-Achdorf, PD Ganslmeier; Krankenhaus Marktredwitz, Dr. Bay, OA Hoffmann; Krankenhaus Mallersdorf, Dr. Mehlhorn; Klinikum Neumarkt, Dr. Schmickal; Klinikum Passau, Dr. Obernhuber; Klinik der Barmherzigen Brüder Regensburg, Prof. Füchtmeier; Krankenhaus St. Josef Regensburg, Prof. Nerlich; Krankenhaus Schwandorf, Dr. Schneider; Klinikum Straubing, Prof. Oedekoven; Krankenhaus Viechtach, Dr. Schäfer; Krankenhaus Vilsbiburg, Dr. Albersdörfer; Krankenhaus Vilshofen, Dr. Rieger; Krankenhaus Waldkrichen, Dr. Schmid; Klinikum Weiden, Dr. Neubaruer- Grartzke; Krankenhaus Zwiesel, Dr. Walter.

Funding

This study is part of the Polytrauma Health Care Quality Outcome (POLYQUALY) Study (“Outcome after major trauma in a certified trauma network: comparing standard vs. maximum care facilities”) and was funded by the German Federal Ministry of Education and Research in the context of a funding program on health services research (01GY1153).

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Authors and Affiliations

  1. Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany

    Katharina Angerpointner, Antonio Ernstberger, Katharina Bosch & Maximilian Kerschbaum

  2. Center for Clinical Studies, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany

    Florian Zeman & Michael Koller

Authors
  1. Katharina Angerpointner
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  2. Antonio Ernstberger
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  3. Katharina Bosch
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  4. Florian Zeman
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  5. Michael Koller
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  6. Maximilian Kerschbaum
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Corresponding author

Correspondence to Maximilian Kerschbaum.

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Conflict of interest

All the authors declare that they have no conflicts of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the University of Regensburg (number 10-101-0077). The study is registered in the data base of the German Network for Healthcare Research (VfD_Polyqualy_12_001978) and in the German Register for Clinical Studies (number DRKS00010039).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Angerpointner, K., Ernstberger, A., Bosch, K. et al. Quality of life after multiple trauma: results from a patient cohort treated in a certified trauma network. Eur J Trauma Emerg Surg 47, 121–127 (2021). https://doi.org/10.1007/s00068-019-01160-y

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  • DOI: https://doi.org/10.1007/s00068-019-01160-y

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