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A new global health outcome score after trauma (GHOST) for disability, cognitive impairment, and health-related quality of life: data from a prospective cross-sectional observational study
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; b Department of Emergency and Intensive Care Medicine , Algarve University Hospital Centre , Faro , Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; b Department of Emergency and Intensive Care Medicine , Algarve University Hospital Centre , Faro , Portugal; c Department of Biomedical Sciences and Medicine , University of Algarve , Faro , Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; d Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine , University of Porto , Porto , Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; d Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine , University of Porto , Porto , Portugal.
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2019 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 33, no 7, p. 922-931Article in journal (Refereed) Published
Abstract [en]

Background:Trauma patients experience morbidity related to disability and cognitive impairment that negatively impact their health-related quality of life (HRQoL). We assessed the impact of trauma on disability, cognitive impairment and HRQoL after intensive care in patients with and without traumatic brain injury (TBI) and created a predictive score to identify patients with worse outcome. Methods:We identified 262 patients with severe trauma (ISSamp;gt;15) admitted to the emergency room of a level 1 trauma center. Patients above 13 years were included. After 6 months, patients were assessed for disability, cognitive impairment, and HRQoL. A global health outcome score after trauma (GHOST) was obtained through the combination of these domains. Logistic regression analysis was considered for the effect of demographic, trauma and hospital factors on global outcome. p amp;gt; 0.05. Statistics performed with SPSS 23.0. Results:Patients with the worst outcomes were older and had a longer length of Intensive Care Unit (ICU) stay. The effect of gender was found in all "GHOST dimensions". TBI was not significantly associated with worse outcome. Conclusions:No significant differences were seen on disability, cognitive impairment and decreased HRQoL in patients with or without TBI. Our GHOST score showed that female gender, older age, and longer ICU stay were significantly associated with the worst outcome. Abbreviations: AIS: Abbreviated Injury Scale; EQ-5D: EuroQol 5-dimensions; EQ-5D-3L: EuroQol 5-dimensions 3-levels; GCS: Glasgow Coma Scale; GOSE: Glasgow Outcome Scale Extended; HRQoL: Health-Related Quality of Life; ICU: Intensive Care Unit; ISS: Injury Severity Score; MMS: Mini Mental State; NICE: National Institute for Health and Care Excellence; RTS: Revised Trauma Score; TBI: Traumatic brain injury; TRISS: Trauma Injury Severity Score; VAS: Visual Analogue Scale.

Place, publisher, year, edition, pages
Informa Healthcare, 2019. Vol. 33, no 7, p. 922-931
Keywords [en]
EQ-5D; GOSE; MMS; TBI; cognitive dysfunction; follow-up
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-164745DOI: 10.1080/02699052.2019.1581257ISI: 000586040800012PubMedID: 30810390Scopus ID: 2-s2.0-85062353380OAI: oai:DiVA.org:liu-164745DiVA, id: diva2:1421374
Available from: 2020-04-02 Created: 2020-04-02 Last updated: 2025-02-11Bibliographically approved

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Orwelius, Lotti

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Faculty of Medicine and Health SciencesANOPIVA USDivision of Surgery, Orthopedics and Oncology
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