Table 1

Study characteristics and methodological aspects of follow-up studies measuring health-related quality of life of injury patients (in order of nr of HRQL instruments used - bold author names are studies of children)

Author, year, country

Study population

HRQL instrument

(mode of administration)

Follow up

(time points and response rates)

Changes over time

Predictors for HRQL


Meerding, 2004, Netherlands [35]

ED and/or admitted

Age 15+

(n = 4639)

EQ-5D

(Self-completed)

2 months (39%)

5 months (24%)

9 months (12%)

Improvements between 2 and 5 months, no further improvement between 5 and 9 months

HRQL associated with body region injured


Polinder, 2005, Netherlands [36]

ED and/or admitted

Age 5-14

(n = 1221)

EQ-5D

(Self-completed, age < 13 proxy)

2.5 month (43%)

5 months (31%)

6 months (30%)

Improvements between 2.5 and 5 months, and between 5 and 9 months

Hospital admission and female gender were predictive for long-term HRQL


Polinder, 2007, Netherlands [37]

ED and/or admitted

Age: >14

(n = 8564)

EQ-5D

(Self-completed)

2.5 month (37%)

5 months (28%)

9 months (27%)

24 months (21%)

Improvement among non admitted patients until 5 months, and among admitted patients until 24 months

Hospitalization, age and sex (females), type of injury and comorbidity were significant predictors of poor functioning in the long term


Vasquez, 1996, Spain [56]

Admitted ICU patients

(n = 351)

GOS

(Self-completed)

Admission

1 year

2 year (% not available)

Quality of life improved the first year and between 1 and 2 years, but after 2 years still below pre-admission summary scores

Long-term HRQL was associated with age, injury severity, and previous quality of life


Hetherington, 1995, UK [28]

Trauma helicopter patients

(n = 100)

FIM

(Face to face interviews)

Acute

3 months

6 months (93%)

Improvements in mobility and self care between 3 and 6 months

HRQL associated with length of hospital stay


Gofin, 1997, Israel [57]

Age 4-17

(n = 281)

ICIDH

(Telephone parent interviews)

Immediately

6 months (85%)

Improvements until 6 months after injury

HRQL is positively associated with ISS


Gofin, 1995, Israel [58]

Age 0-17

(n = 432)

ICIDH

(Telephone parent interviews)

Immediately

6 months (85%)

Improvements until 6 months after injury

HRQL associated with child's age and parental proxy age


Holbrook, 1998, US [14]

>24 hours admitted in trauma center

Age 18+

GCS >11

(n = 1048)

QWB-scale

(Face to face interviews)

Pre-injury

Discharge

6 months (79%)

Significant degree of functional limitations at discharge compared to pre-injury scores.

Post-injury depression, PTSD, serious extremity injury, and length of stay were significant predictors of HRQL


Holbrook, 1999, US [15]

>24 hours admitted in trauma center

Age 18+

GCS >11

(n = 1048)

QWB-scale

(Face to face interviews)

Pre-injury

Discharge (79%)

12 months (79%)

18 months (74%)

Improvement between discharge and 12 months, but no improvements between 12 and 18 months.

Post-injury depression, PTSD, serious extremity injury, and intensive care unit days were significant independent predictors of HRQL


Holbrook, 2004, US [16]

>24 hours admitted in trauma center

Age 18+

GCS >11

(n = 1048)

QWB-scale

(Face to face interviews)

Discharge (79%)

6 months (79%)

12 months (74%)

18 months (74%)

Improvement between 6 and 12 months

Gender (women) was a significant independent predictors of HRQL at all follow-up time points


Gabbe, 2007, Australia [31]

Admitted

Age 18 -64

(n = 1033)

SF-12

(Telephone interviews)

Pre-injury

12 months (69%)

After 12 months patients were not returned to their pre-injury status

Compensable patients were more likely than non-compensable patients to report moderate to severe HRQL


Brenneman, 1997, Canada [59]

Admitted

ISS >10

(N = 195)

SF-36

(Telephone interviews)

Discharge (56%)

12 months (44%)

Improvements between discharge and 12 months

Better scores on 7 dimensions of the SF-36 for patients who returned to work


Michaels, 1999, US [20]

Admitted to trauma centre

Age 18+

(n = 247)

SF-36

(Self-completed)

Admission (100%)

6 months (75%)

12 months (51%)

Improvements between baseline and 6 months, and between 6 and 12 months

Mental health (PTSD) is an independent predictor of HRQL


Kopjar, 1996, Norway [60]

Treated for injury

Age 16-78

(n = 775)

SF-36

(Self-completed)

6-10 weeks (61%)

24-28 weeks (63%)

Improvements between 2 and six months

HRQL associated with activity restrictions


Macpherson, 2003, Canada [39]

Hospital inpatients

Age 2-15

ISS >12

(n = 489)

WeeFIM

(Telephone interviews)

Discharge

6 months (73%)

Improvement between discharge and 6 months

Injury mechanism is an independent predictor of HRQL


Aitken, 2002, US [11]

Admitted to children's hospital

Age 3-18

ISS > 3

(n = 310)

CHQ PF-50, WeeFIM

(Parent interview, child Self-completed)

Discharge 63%)

1 month (56%)

6 months (45%)

Improvements between 1 and 6 months

HRQL associated with level of injury severity


Winthrop, 2005, US [21]

Admitted

Age 1-18

ISS > 8

(n = 180)

CHQ, FIM

(Face-to-face interviews)

Discharge (90%)

1month

6 months (87%)

12 months

Improvements between baseline and 1 month, and between 1 and 6 months

HRQL associated with injury severity


Baldry Currens, 2000, UK [24,25]

Survivors of major trauma Admitted >3 days

Age 5+

(n = 251)

FIM, GOS

(Telephone interviews)

3 months (80%)

6 months

12 months

> 24 months

Improvements between 3 and 6 months

No further improvement between 6 months and 1 year

HRQL associated with major vs. minor injury and body region injured


Gillen, 2004, US [13]

Age 20+

(n = 114)

SF-36, HAQ

(Telephone interviews)

1 week

2 weeks

1 month

3 months (79%)

Improvements between 1 week and 2 weeks, between 2 weeks and 1 month, and between 1 and 3 months.

The SF-36 and the HAQ were responsive to clinical changes in varying conditions and the SF-36 was sensitive to changes in traumatic injuries.


Kiely, 2006, US [18]

Age 18-55

ISS > 8 and all patients with age 55+

(n = 312)

SF-36, FIM

(Telephone interview or self-completed)

1 month (63%)

6 months (39%)

Improvements between 1 and 6 months post injury

Functional status, PTSD, social support, and depression were predictors of HRQL


Soberg, 2007, Norway [43]

Admitted to trauma centre

ISS > 15

Age 18-67

(n = 169)

SF-36, WHODASH II

(Self-completed)

6 weeks (62%)

1 year (61%)

2 years (60%)

Improvements, except for mental and general health between 6 wk and1 year. Between 1 and 2 years almost no improvements.

Profession, injury severity, pain, and physical, cognitive, and social functioning made independent contributions to WHODAS II 2 years after injury


Evanoff, 2002, US [12]

Workers > 5 days workdays lost (n = 934)

SF-36, SF-12, DASH short version

(Face to face interviews)

Baseline (33%)

6 months (27%)

Improvement over 6 months, after 6 months continuing HRQL

No


Watson, 2005, Australia [33]

Admitted

Age 18-74

(n = 221)

SF-36, AQol, SF-6D

(Face-to-face interviews)

Pre-injury

1, 6, 12 weeks

6 months

12 months (84%)

Significant improvement of functional outcome till 6 months; no significant difference in summary scores at 6 and 12 months post-injury

The AQoL showed good discrimination between groups for type of injury, body region injured and severity of injury


Watson, 2007, Australia [33]

Admitted

Age 18-74

(n = 186)

SF-36, AQol, SF-6D

(Face-to-face interviews)

Pre-injury

12 months (88%)

No difference between summary scores at baseline and 12 months after injury for patients that completely recovered

Gender, age, working status were predictors for complete recovery after one year


Gabbe, 2008, Australia [32]

Age 15-80

ISS > 15

(n = 243)

FIM, Modified FIM, GOS, GOS-E

(Telephone interviews with participants or care provider)

Discharge

6 months (97%)

Improvement between discharge and 6 months, except for the cognition component of the FIM

HRQL associated with discharge destination and head injury vs. no head injury


Sutherland, 2005, UK [29]

Admitted

Age 16-70

(n = 200)

SF-36, SF-6D, MFA, GHQ

(Self-completed)

2 months (79%)

6 months (75%)

No improvement between 2 and 6 months

No


AMA-guides = American Medical Association guides; BDS = Bull Disability Scale; CFS = Cognitive Function Scale; CHQ PF-50 = Parent Completed version of the CHQ; CHQ = Child Health Questionnaire; EQ5 D = European Quality of life instrument-5 dimensions;; FIM = Functional Independence Measure; GHQ = General Health Questionnaire; GOS = Glasgow Outcome Scale; HAQ = Health Assessment Questionnaire; HOBQ = Health Outcomes Burn Questionnaire for Children; ICIDH2 = 25 item scale for measuring functional outcome by the International Classification of Impairments Disabilities and Handicaps; MFA = Musculoskeletal Functional Assessment; NHP = Nottingham Health Profile; OPCS = Office of Population Census and Surveys national survey of disability in Great Britain; QOL = Satisfaction with Quality of Life instrument; QWB = Quality of Well Being scale; RDS = Rosser Disease Score; RTW = Return To pre-injury Work status; SF-6D = Medical Outcome Study Short Form-6 dimensions; SF-12 = Medical Outcome Study Short Form-12 items; SF-36 = Medical Outcome Study Short form-36 items; SIP = Sickness Impact Profile; TOP = Trauma Outcome Profile; WeeFIM = Pediatric version of the FIM; WODASII = World Health Organization Disability Assessment Schedule version II; WHOQOL-BREF = short version of the World Health Organization Quality of life.

Polinder et al. BMC Public Health 2010 10:783   doi:10.1186/1471-2458-10-783

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