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ORIGINAL ARTICLE Open
Italian Journal of Emergency Medicine 2020 December;9(3):188-94
DOI: 10.23736/S2532-1285.20.00054-3
Copyright © 2020 THE AUTHORS
This is an open access article under the CC BY-NC-ND license
language: English
Quality of life 1-7 years after a mild to moderate trauma
Francesca INNOCENTI ✉, Federica TRAUSI, Chiara GIGLI, Alessandro COPPA, Rita AUDISIO, Stefano CALCAGNO, Irene TASSINARI, Riccardo PINI
High-Dependency Observation Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Florence, Italy
BACKGROUND: Few data are available about the impact of a mild to moderate trauma on the health-related quality of life (HRQOL). Aims of the present study were: 1) to evaluate HRQOL 1-7 years after a mild to moderate trauma; and 2) to study possible determinants of the HRQOL reduction.
METHODS: We performed a follow-up (FU) observational study of a cohort of 416 trauma patients admitted to the ED-HDU of the University Hospital of Florence from July 2008 to December 2014. A follow-up based on telephone interviews using the physical (PCS) and mental (MCS) health composite score (SF12) was conducted between October 2015 and February 2016.
RESULTS: The study population included 351 patients; mean PCS was 43±12 and mean MCS 49±13. About one third of the population showed an abnormal PCS (36%) or MCS (23%) score; 19%, 21% and 16% of patients reported a mild, moderate or severe disability in the physical dimension; and 17%, 14% and 11% in the mental dimension. In a stepwise multivariable analysis, in the first step, we included demographic and anamnestic parameters: an advanced age (HR: 1.03, 95% CI: 1.01-1.04), presence of comorbidities (HR: 2.31, 95% CI: 1.30-4.11) and female gender (HR: 1.91, 95% CI: 1.14-3.19) were significantly associated with an abnormal PCS. In the second step, we added the variables related to trauma severity: a longer LOS (HR: 1.04, 95% CI: 1.01-1.07) entered in the model, alongside the aforementioned variables. An advanced age (HR: 1.03, 95% CI: 1.01-1.05) predicted an abnormal MCS score in both steps.
CONCLUSIONS: After a mild to moderate trauma, a significant proportion of patients reported a reduced HRQOL; the condition before trauma played a pivotal role in determining an abnormal HRQOL.
KEY WORDS: Wounds and injuries; Prognosis; Quality of life