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Beyond pain and disability: The lasting effects of trauma on life after injury.
Hatchimonji, Justin S; Kaufman, Elinore J; Babalola, Deborah; Candido, Katelyn; Chreiman, Kristen; Jackson, Sunny; Reilly, Patrick M; Seamon, Mark J.
Afiliación
  • Hatchimonji JS; From the Department of Surgery (J.S.H.), Division of Traumatology, Emergency Surgery, and Surgical Critical Care (E.J.K., K.C., S.J., P.M.R., M.J.S.), Perelman School of Medicine at the University of Pennsylvania; and School of Arts and Sciences (D.B., K.C.), University of Pennsylvania, Philadelphia, Pennsylvania.
J Trauma Acute Care Surg ; 93(3): 332-339, 2022 09 01.
Article en En | MEDLINE | ID: mdl-35546735
BACKGROUND: The impact of traumatic injury likely extends beyond direct physical consequences and lasts well beyond the acute injury phase. Data collection is sparse after hospital discharge, however. In this observational study, we hypothesized that sequelae of injury would last at least 6 months and sought to prospectively determine patient-reported physical, emotional, and social outcomes during this postinjury period. METHODS: We surveyed patients admitted to our Level I trauma center (July 2019 to October 2020) regarding baseline functioning and quality of life after injury, using the Patient-Reported Outcomes Measurement Information System (PROMIS-29) instrument, a primary care posttraumatic stress disorder screen, and questions on substance use, employment, and living situation. Patients were re-surveyed at 6 months. PROMIS-29 scores are reported as t scores compared with the US population. Differences between groups were analyzed using χ 2 , signed-rank, and t tests, with paired tests used for changes over time. RESULTS: Three hundred sixty-two patients completed the baseline, 130 of whom completed 6-month follow-up. Those completing the 6-month survey were similar ages (43.3 ± 17.8 vs. 44.4 ± 19.0, p = 0.57), mechanism (24.7% vs. 28.0% shot or stabbed, p = 0.61), and severities (median Injury Severity Score, 9 vs. 9; p = 0.15) as those who only completed the baseline. There were 55.0% reported being hospitalized for an injury previously. Patients reported decreases in ability to participate in social roles and activities (mean t score 51.4 vs. 55.3; p = 0.011) and increases in anxiety (53.8 vs. 50.5, p = 0.011) and depression (51.0 vs. 48.7, p = 0.025). There were 26.2% that screened positive for posttraumatic stress disorder at 6 months. Employment decreased at 6 months, with 63.9% reporting being "occasionally" employed or unemployed at 6 months versus 44.6% preinjury ( p < 0.001). CONCLUSION: The effects of injury extend beyond pain and disability, impacting several realms of life for at least 6 months following trauma. These data support the development of screening and intervention protocols for postinjury patients. LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level IV.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Personas con Discapacidad Tipo de estudio: Observational_studies / Prognostic_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: J Trauma Acute Care Surg Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Personas con Discapacidad Tipo de estudio: Observational_studies / Prognostic_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: J Trauma Acute Care Surg Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos