The effects of pelvic ring injuries on quality of life, physical, and mental health: results of a 2-year prospective cohort study.

Autor: Banierink H; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. h.banierink@umcg.nl., Ten Duis K; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Meesters AML; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Trouwborst NM; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Heineman E; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Wendt KW; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Ploegmakers JJW; Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Reininga IHF; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.; Emergency Care Network Northern Netherlands (AZNN), Northern Netherlands Trauma Registry, Groningen, The Netherlands., IJpma FFA; Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2022 Aug; Vol. 48 (4), pp. 2849-2857. Date of Electronic Publication: 2022 Mar 05.
DOI: 10.1007/s00068-022-01893-3
Abstrakt: Purpose: Pelvic ring injuries are known to affect the patients' daily life in terms of physical functioning and quality of life (QoL). Still, prospective studies on the patient's perception over the first 2 years of rehabilitation are lacking. Therefore, patients cannot be properly informed about whether or when they will return to their pre-existing level of physical functioning and QoL.
Methods: A prospective longitudinal cohort study was performed over a 4-year period including all consecutive patients above 18 years who sustained a pelvic ring injury in a level 1 trauma center. Validated patient-reported outcome measures (PROMs) were used to assess physical functioning (SMFA) and QoL (EQ-5D) at baseline (recalled pre-injury score), 6 weeks, 3 months, 6 months, 1 year and 2 years after the injury. It was assessed whether patients had fully recovered by comparing follow-up scores to baseline PROMs. Binary logistic regression analysis was used to identify independent predictors for patients who did not fully recover. Most experienced difficulties at 3 months and 1 year were identified by analyzing the highest reported scores on individual items of the SMFA.
Results: A total of 297 patients with a pelvic ring injury were identified of which 189 were eligible for follow-up and 154 (82%) responded. Median SMFA function score at 3 months, 1 and 2 years was 70, 78 and 88, respectively, compared to 96 out of 100 before the injury. Median SMFA bother score was 67, 79 and 88, respectively. Median EQ-5D score at 3 months, 1 and 2 years was 0.61, 0.81 and 0.85, respectively, compared to 1 (maximum achievable) before the injury. After 1 and 2 years of follow-up, 61% and 75% of the patients fully "recovered" in physical functioning and 52% and 71% fully recovered in terms of QoL. Female gender and high-energy trauma were independent predictors for not fully recovering after 1 year. After 3 months of follow-up, 54% of patients reported severe difficulties with recreational activities, whereas after 1 year, most experienced difficulties (31% of patients) concerned heavy house or yard work. Moreover, after 3 months and 1 year, 44% and 27% of patients reported feeling physically disabled.
Conclusion: Pelvic ring injuries have a large impact on the patients' daily life in the first 2 years of rehabilitation. Directly after the injury, physical functioning and QoL decrease strongly but then gradually improve over a 2-year period with about 75% of patients fully recovering. Female gender and high-energy trauma are shown to be independent predictors for not fully recovering. After 3 months, patients experience difficulties with both the physical and mental effects of the injury which continue to be present after 1 year.
(© 2022. The Author(s).)
Databáze: MEDLINE
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