Implementation of health-related quality of life in the German TraumaRegister DGU® - first results of a pilot study

Jaekel C, Nienaber U, Neubert A, Kamp O, Wienhöfer L, Nohl A, Maegele M, Duesing H, Erichsen CJ,Frenzel S, Lefering R, Flohe S, Bieler D, Outcome Study Group of the Committee on EmergencyMedicine, Intensive Care, Trauma Management (Sektion NIS) of the German Trauma Society (DGU)

Abstract

Background Approximately 30,000 people are afected by severe injuries in Germany each year. Continuous progress in prehospital and hospital care has signifcantly reduced the mortality of polytrauma patients. With increasing survival rates, the functional outcome, health-related quality (hrQoL) of life and ability to work are now gaining importance. Aim of the study is, the presentation of the response behavior of seriously injured patients on the one hand and the examination of the factors infuencing the quality of life and ability to work 12 months after major trauma on the other hand. Building on these initial results, a standard outcome tool shall be integrated in the established TraumaRegister DGU® in the future. Methods In 2018, patients [Injury Severity Score (ISS)≥16; age:18–75 years] underwent multicenter one-year posttraumatic follow-up in six study hospitals. In addition to assessing hrQoL by using the Short-Form Health Survey (SF-12), fve additional questions (treatment satisfaction; ability to work; trauma-related medical treatment; relevant physical disability, hrQoL as compared with the prior to injury status) were applied. Results Of the 1,162 patients contacted, 594 responded and were included in the analysis. The post-injury hrQoL does not show statistically signifcant diferences between the sexes. Regarding age, however, the younger the patient at injury, the better the SF-12 physical sum score. Furthermore, the physically perceived quality of life decreases statistically signifcantly in relation to the severity of the trauma as measured by the ISS, whereas the mentally perceived quality of life shows no diferences in terms of injury severity. A large proportion of severely injured patients were very satisfed (42.2%) or satisfed (39.9%) with the treatment outcome. It should be emphasized that patients with a high injury severity (ISS>50) were on average more often very satisfed with the treatment outcome (46.7%). A total of 429 patients provided information on their ability to work 12 months post-injury. Here, 194 (45.2%) patients had a full employment, and 58 (13.5%) patients were had a restricted employment. Conclusion The present results show the importance of a structured assessment of the postinjury hrQoL and the ability to work after polytrauma. Further studies on the detection of infuenceable risk factors on hrQoL and ability to work in the intersectoral course of treatment should follow to enable the best possible outcome of polytrauma survivors