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Outcomes der Funktionsfähigkeit bei Polytrauma

Messinstrumente und Konzepte, ein systematischer Review

Systematic review of measurement instruments and concepts used for functioning outcome in multiple trauma

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Zusammenfassung

Unfälle und schwere Verletzungen, insbesondere Polytraumen, sind in der Bevölkerung unter 50 Jahren nach wie vor die häufigsten Todesursachen sowie eine wichtige Ursache bleibender Behinderung. Es ist daher wichtig, patientenrelevante Verletzungsfolgen nach dem Akutereignis langfristig und kontinuierlich zu überwachen. Eine entsprechende Übersicht für Instrumente zu den Behandlungsergebnissen von Polytrauma fehlt bisher. Als Systematik zum Vergleich von Messinstrumenten hat sich die Internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) bewährt. Wir führten eine systematische Suche der elektronischen Datenbanken Medline und Embase für die Jahre 2000 bis 2006 durch. Daten der verwendeten Messinstrumente wurden extrahiert, die entsprechenden Konzepte identifiziert und mit Hilfe der ICF kodiert. Eingeschlossen wurden 117 Studien mit insgesamt 112 Messinstrumenten; 1032 verschiedene Konzepte wurden extrahiert, davon konnten 93% kodiert werden. Die vorliegende Literatursuche bestätigt, wie vielfältig und heterogen die Probleme sind, mit denen Menschen nach der akuten Phase eines Polytraumas konfrontiert sind. Ein homogenes Messkonzept hierfür wäre wichtig.

Abstract

Multiple trauma and injuries are the main causes for mortality and long term disability in the younger population under 50 years old. Monitoring patient-relevant long term consequences after an acute event is therefore of high importance. However, there is no systematic overview on the assessment instruments and their concepts used to monitor long term outcome of multiple trauma. The International Classification of Functioning, Disability and Health (ICF) is a framework to standardize and compare assessment instruments. We conducted a systematic search of the electronic databases Medline and Embase covering the years 2000 to 2006 and data on utilized instruments were extracted from the retrieved studies. The corresponding concepts were identified and coded using the ICF. A total of 117 studies with 112 instruments were included and 1,032 different concepts were extracted of which 93% could be coded. This review confirms the heterogeneity and complexity of the problems encountered after multiple trauma. A homogeneous concept for assessment of long term outcome is warranted.

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Authors and Affiliations

  1. Institut für Gesundheits- und Rehabilitationswissenschaften (IHRS), Research Unit for Epidemiology of Functioning and Health, Ludwig-Maximilians-Universität München, Marchioninistr. 17, 81377, München, Deutschland

    E. Grill MPH, R. Mittrach & M. Müller

  2. ICF Research Branch des WHO FIC CC (DIMDI), Nottwil, Schweiz

    E. Grill MPH, R. Mittrach & M. Müller

  3. Chirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Innenstadt, München, Deutschland

    W. Mutschler

  4. Klinik und Poliklinik für Physikalische Medizin und Rehabilitation, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland

    S.R. Schwarzkopf

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  1. E. Grill MPH
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  2. R. Mittrach
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  3. M. Müller
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  4. W. Mutschler
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  5. S.R. Schwarzkopf
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Correspondence to E. Grill MPH.

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Grill, E., Mittrach, R., Müller, M. et al. Outcomes der Funktionsfähigkeit bei Polytrauma. Unfallchirurg 113, 448–455 (2010). https://doi.org/10.1007/s00113-010-1744-5

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