出院严重创伤患者健康相关生活质量的预测因素系统回顾和荟萃分析

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-12 DOI:10.1016/j.jcot.2025.103102

Zemedu Ferede , Arpita Das , Silvia Manzanero , Vignesh Raman , Michael Schuetz , Dylan Flaws

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引用次数: 0

摘要

背景：尽管创伤系统的进步提高了生存率，但长期的康复结果，如健康相关的生活质量（HRQOL），往往被忽视。确定预测出院后HRQOL的因素有助于指导个性化护理和优先考虑需要出院后随访的患者。本综述旨在综合重大创伤患者出院后HRQOL预测因素的证据。方法本综述在PROSPERO注册（CRD42024512689），通过PubMed、Embase、Scopus、Cochrane Library和CINAHL等数据库进行检索。预后质量研究（QUIPS）用于评估偏倚风险。采用建议分级、评估、发展和评价（GRADE）框架评估证据质量。meta分析采用Stata v-17评估预测变量对HRQOL的影响。结果纳入17项研究（n = 14项前瞻性研究，n = 3项回顾性队列研究），其中7项纳入meta分析。在大多数研究中，偏倚的总体风险是中等的。年龄越大，EuroQol 5- dimension （EQ-5D）和Short Form 36 Health Survey (SF-36) Physical Component Score （PCS）越低，SF-36 Mental Component Score （MCS）越高。荟萃分析显示，女性预示着SF-36-MCS和EQ-5D较低。美国麻醉学学会（ASA）评分越低，EQ-5D越低，精神共病越低，SF-36-MCS越低。损伤严重程度评分（ISS）越高，HRQOL越差，SF-36-MCS和PCS越差。创伤性脑损伤（TBI）预测SF-36-MCS较差，但其他损伤部位不能预测长期HRQOL。虽然住院时间没有预测作用，但大多数与医院相关的因素仅在一项研究中被报道。结论年龄、性别、既往病史、损伤严重程度等出院前因素是患者长期HRQOL较差的重要预测因素。了解这些预出院因素对改善长期预后非常重要。进一步的研究应包括医院治疗和诊断因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Predictors of health-related quality of life among major trauma patients discharged from hospitals. A systematic review and meta-analysis

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Predictors of health-related quality of life among major trauma patients discharged from hospitals. A systematic review and meta-analysis

Background

Despite advances in trauma systems that improve survival, long-term recovery outcomes, such as health-related quality of life (HRQOL), are often overlooked. Identifying the factors that predict post-discharge HRQOL can help guide personalized care and prioritize patients who need post-discharge follow-up. This review aimed to synthesize evidence on predictors of post-discharge HRQOL among major trauma patients.

Methods

This review was registered with PROSPERO (CRD42024512689) and conducted using searches across databases including PubMed, Embase, Scopus, Cochrane Library, and CINAHL. The Quality in Prognosis Studies (QUIPS) was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was applied to assess quality of evidence. The meta-analysis was performed to evaluate the effect of predictor variables on the HRQOL using Stata v-17.

Results

Seventeen studies were included (n = 14 prospective, n = 3 retrospective cohort studies), and 7 of these were incorporated into the meta-analysis. The overall risk of bias was moderate in most studies. Older age predicts lower EuroQol 5-Dimensions (EQ-5D) and lower Short Form 36 Health Survey (SF-36) Physical Component Score (PCS), while it predicts a higher SF-36 Mental Component Score (MCS). Meta-analysis showed that female sex predicted lower SF-36-MCS and lower EQ-5D. A lower American Society of Anesthesiology (ASA) score predicted lower EQ-5D, while psychiatric comorbidity predicted lower SF-36-MCS. Higher Injury Severity Score (ISS) predicted poor HRQOL, but not SF-36-MCS and PCS. Traumatic Brain Injury (TBI) predicted poor SF-36-MCS, but other injury locations did not predict long-term HRQOL. While the length of hospital stay showed no predictive effect, most hospital-related factors were reported in only a single study.

Conclusion

Predischarge factors, such as age, sex, preexisting conditions, and injury severity, are significant predictors of poor long-term HRQOL. Knowledge of these predischarge factors is important to improve long-term outcomes. Additional research should include hospital treatment and diagnostic factors.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.