Trajectory of functional outcome and health status after moderate-to-major trauma in Hong Kong: A prospective 5 year cohort study.

Autor: Rainer TH; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; School of Medicine, Cardiff University, United Kingdom., Hung KKC; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong., Yeung JHH; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong., Cheung SKC; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong., Leung YK; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong., Leung LY; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong., Goggins WB; JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong., Ho HF; Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong., Kam CW; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Accident and Emergency Department, Tuen Mun Hospital, Hong Kong., Cheung NK; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong., Graham CA; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong. Electronic address: cagraham@cuhk.edu.hk.
Jazyk: angličtina
Zdroj: Injury [Injury] 2019 May; Vol. 50 (5), pp. 1111-1117. Date of Electronic Publication: 2019 Feb 22.
DOI: 10.1016/j.injury.2019.02.017
Abstrakt: Background: Trauma care systems in Asia have been developing in recent years, but there has been little long-term outcome data from injured survivors. This study aims to evaluate the trajectory of functional outcome and health status up to five years after moderate to major trauma in Hong Kong.
Methods: We report the five year follow up results of a multicentre, prospective cohort from the trauma registries of three regional trauma centres in Hong Kong. The original cohort recruited 400 adult trauma patients with ISS ≥ 9. Telephone follow up was conducted longitudinally at seven time points, and the extended Glasgow Outcome Scale (GOSE) and Short-Form 36 (SF36) were tracked.
Results: 119 out of 309 surviving patients (39%) completed follow up after 5 years. The trajectory of GOSE, PCS and MCS showed gradual improvements over the seven time points. 56/119 (47.1%) patients reported a GOSE = 8 (upper good recovery), and the mean PCS and MCS was 47.8 (95% CI 45.8, 49.9) and 55.8 (95% CI 54.1, 57.5) respectively at five years. Univariate logistic regression showed change in PCS - baseline to 1 year and 1 year to 2 years, and change in MCS - baseline to 1 year were associated with GOSE = 8 at 5 years. Linear mixed effects model showed differences in PCS and MCS were greatest between 1-month and 6-month follow up.
Conclusions: After injury, the most rapid improvement in PCS and MCS occurred in the first six to 12 months, but further recovery was still evident for MCS in patients aged under 65 years for up to five years.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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