scholarly journals A study of patients’ quality of life more than 5 years after trauma: a prospective follow-up

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fanny Vardon-Bounes ◽  
Romain Gracia ◽  
Timothée Abaziou ◽  
Laure Crognier ◽  
Thierry Seguin ◽  
...  

Abstract Background The long-term fate of severely injured patients in terms of their quality of life is not well known. Our aim was to assess the quality of life of patients who have suffered moderate to severe trauma and to identify primary factors of long-term quality of life impairment. Methods A prospective monocentric study conducted on a number of patients who were victims of moderate to severe injuries during the year 2012. Patients were selected based on an Injury Severity Score (ISS) more than or equal to 9. Quality of life was assessed by the MOS SF-36 and NHP scores as a primary evaluation criterion. The secondary evaluation criteria were the determination of the socio-economic impact on quality of life and the identification of factors associated with disability. Results Two hundred and eight patients were contacted by e-mail or telephone. Fifty-five patients participated in this study (with a participation level of 26.4%), including 78.2% men, with a median age of 46. Significant alterations in quality of life were observed with the NHP and MOS SF-36 scale, including physical and psychological components. This resulted in a major socio-economic impact as 26% of the patients could not resume their professional activities (n = 10), 20% required retraining in other lines of work, and 36.4% had a disability status. The study showed that scores ≤ 85 on the physical functioning variable of the MOS SF 36 scale was associated with disability. Conclusion More than five years after a moderate to severe injury, patients’ quality of life was significantly impacted, resulting in significant socio-economic consequences. Disability secondary to major trauma seems to be associated with a score ≤ 85 on the physical functioning dimension of the MOS SF-36 scale. This study raises the question of whether or not early rehabilitation programs should be implemented in order to limit the long-term impact of major trauma.

Author(s):  
K. V. Duve

The analysis of data from a number of scientific sources shows that even those patients, with favorable outcomes after suffering from aneurysmal subarachnoid hemorrhage (aSAH), may often experience a decline in quality of life (QoL), both at the physical and psychosocial levels. The influence of functional dependence on the patient’s quality of life remains controversial, because among the number of patients, who save the ability of self-care, there exists a part of those, who are not able to return to their previous lifestyle, kind of activity, they have difficulties in their relationships and emotional disorders. The aim of study was to assess the quality of life of patients in recovery and residual periods of aSAH. Material and methods. We examined 114 patients (64.91 % - males, 35.09 % - females). The patients’ quality of life was studied by using the questionnaire SF-36. The control group consisted of 20 healthy participants, matched by age and gender. Results. The significant decrease in QoL of patients was observed in all scales, with the exception of physical functioning, vital activity and social functioning. It should be noted, that "mental health" scale rates correlated with the level of anxiety (r = -0,55) and depression (r = -0,61). In the different age groups, the QoL indicators were almost identical, with the exception of "physical functioning" component, because older patients received a lower score for this scale (p<0.01). Patients with a moderate level of disability were observed with a decline in all QoL categories of the scale SF-36. Patients, who were totally independent, had also a significant decline in all QoL scale components, with the exception of physical functioning. Conclusions. We found the decrease in QoL of patients in recovery and residual periods of aSAH, which does not depend on one’s level of functional dependence. The influence of anxiety (r = -0,55) and depression (r = -0,61) on the subscale "mental health" was established.


Author(s):  
K. V. Duve

The analysis of data from a number of scientific sources shows that even those patients, with favorable outcomes after suffering from aneurysmal subarachnoid hemorrhage (aSAH), may often experience a decline in quality of life (QoL), both at the physical and psychosocial levels. The influence of functional dependence on the patient’s quality of life remains controversial, because among the number of patients, who save the ability of self-care, there exists a part of those, who are not able to return to their previous lifestyle, kind of activity, they have difficulties in their relationships and emotional disorders. The aim of study was to assess the quality of life of patients in recovery and residual periods of aSAH. Material and methods. We examined 114 patients (64.91 % - males, 35.09 % - females). The patients’ quality of life was studied by using the questionnaire SF-36. The control group consisted of 20 healthy participants, matched by age and gender. Results. The significant decrease in QoL of patients was observed in all scales, with the exception of physical functioning, vital activity and social functioning. It should be noted, that "mental health" scale rates correlated with the level of anxiety (r = -0,55) and depression (r = -0,61). In the different age groups, the QoL indicators were almost identical, with the exception of "physical functioning" component, because older patients received a lower score for this scale (p<0.01). Patients with a moderate level of disability were observed with a decline in all QoL categories of the scale SF-36. Patients, who were totally independent, had also a significant decline in all QoL scale components, with the exception of physical functioning. Conclusions. We found the decrease in QoL of patients in recovery and residual periods of aSAH, which does not depend on one’s level of functional dependence. The influence of anxiety (r = -0,55) and depression (r = -0,61) on the subscale "mental health" was established.


2006 ◽  
Vol 64 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Mara Renata Fernandes ◽  
Luciane B.C. Carvalho ◽  
Gilmar F. Prado

CONTEXT: Hemiparesia changes quality of life of patients with stroke making difficult a normal life. OBJECTIVE: To evaluate the effect of Functional Eletric Orthesis (FEO) applied over the paretic leg in the quality of life of stroke patients. METHOD: The quality of life of 50 stroke patients of Associacao de Assistencia a Crianca Deficiente (AACD) was evaluated with SF-36 questionnaire before and after the treatment with a FEO for rehabilitation of walking. We analyzed data according to gender and affected hemisphere. RESULTS: The average values from all domains of SF-36 improved significantly (p<0.001). Female patients improved more than male in Emotional Domain (p=0.04) and presented a trend to be better regarding Bodily Pain and Social Functioning. Patients with right hemiparesia improved more than those with left hemiparesia (p=0.02). CONCLUSION: FEO over a paretic leg is efficient to improve quality of life of stroke patients, mainly Physical Functioning.


2000 ◽  
Vol 6 (5) ◽  
pp. 338-342
Author(s):  
J HA Arnoldus ◽  
J Killestein ◽  
L EMA Pfennings ◽  
B Jelles ◽  
B MJ Uitdehaag ◽  
...  

Objectives: To determine the quality of life (QoL) of MS patients during the initial 6 months of treatment with interferon-b (IFN-b). Furthermore, to determine whether changes in QoL relate to disability, emotional state, therapeutic expectations or side effect profile. Background: IFN-b has been shown to have beneficial effects on the course of MS. Since the aim of IFN-b treatment is not to cure but to slow down the disease it is important to know how this treatment affects QoL. Surprisingly, the impact of treatment with IFN-b on QoL measures has not been extensively studied so far. Methods: Case report documentation, including EDSS, SF-36 and MADRAS scores, of 51 relapsing-remitting MS patients treated with IFN-b was obtained at baseline and at months 1, 3 and 6. Patients also filled in a form about their expectations of therapy and a questionnaire on side effects. Results: During treatment there was a significant linear trend indicating improvement in the role-physical functioning (RPF) scale of the SF-36 (F1,50=4.9, P=0.032). A transient decrease at month 1 was found in the scale for bodily pain, indicating more experienced pain (F1,50=19.8, P50.001). Subgroup analysis showed that patients with most depressive symptoms on the MADRAS at baseline contributed most to the increase in RPF scores over time (F1,24=5,6 P=0.026). Furthermore, we found associations between adverse event scores and several domains of QoL. Conclusions: Our findings suggest that IFN-b therapy has an impact on QoL of MS patients in that it improves role-physical functioning and transiently worsens experienced bodily pain. QoL during treatment with IFN-b is influenced by depressive symptoms at baseline as well as by treatment-associated side-effects.


2018 ◽  
Vol 10 (4) ◽  
pp. 65-71
Author(s):  
Yu. N. Bykov ◽  
T. B. Bender ◽  
Yu. N. Vasiliev ◽  
A. N. Kalyagin ◽  
Т. М. Maksikova ◽  
...  

Motor and non-motor symptoms are identified in the clinical picture of Parkinson's disease (PD). Among its non-motor manifestations, cognitive impairment (CI) and emotional disorders play a special role in PD. It is important to search for new forms and methods of cognitive therapy in patients with PD.Objective:to analyze neuropsychological status and quality of life (QOL) in PD patients and to evaluate the efficiency of personalized combination therapy with a stimulating cognitive motor training on computer and mobile devices in these patients.Patients and methods. The investigation enrolled 112 patients with PD. A study group included 56 PD patients who received a cycle of combination therapy with cognitive-motor training on PC and mobile devices; a control group consisted of 56 PD patients who had only a drug therapy cycle. To evaluate neuropsychological status and QOL, the investigators used the Montreal Cognitive Assessment (MoCA), the McNair and Kahn memory self-evaluation scale, the Hospital Anxiety and Depression Scale (HADS), and the 36-Item Short Form Health Survey (SF-36) questionnaire.Results and discussion. According to MoCA scores, CI of varying severity was diagnosed in the majority of patients: in 75 and 80.4% in the study and control groups, respectively. Depressive syndrome was detected in 53.6 and 64.3% in these groups, respectively. According to the SF-36, the physical status of patients had the greatest effect in reducing their QOL. There were treatment-induced statistically significant positive changes for the following domains: physical functioning (p<0.01), role-physical functioning (p<0.001), pain intensity (p<0.01), general health (p<0.01), role emotional (p<0.0001), and mental health (p<0.01).Conclusion.The investigation has shown the efficiency of personalized therapy including stimulating cognitive-motor training on computer and mobile devices, which improves neuropsychological status and QOL in patients with PD.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Bianco ◽  
M Colaneri ◽  
V Bucciarelli ◽  
FC Surace ◽  
FC Iezzi ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background  To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). Methods  In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years. Results  At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011). Conclusions  In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.


2001 ◽  
Vol 94 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Helen C. Martin ◽  
Jagjit Sethi ◽  
Dorothy Lang ◽  
Glen Neil-Dwyer ◽  
Mark E. Lutman ◽  
...  

Object. The aim of this study was to assess whether outcomes from excision of acoustic neuroma vary among patients and have a material impact on their quality of life (QOL). Methods. A questionnaire concerning postoperative symptoms and the Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who had undergone acoustic neuroma surgery via the translabyrinthine approach. The survey response rate was 78% and the symptomatology was consistent with other reports, supporting the representativeness of the sample. The respondents' QOL was rated significantly below published norms and their work capacity was reportedly reduced. Specifically, the following SF-36 dimensions were reduced: physical functioning and role-physical, together with vitality, general health, and social functioning. Greater numbers of postoperative symptoms and larger tumors were associated with a worse rating of physical functioning. More severe balance problems were associated with lower ratings of social functioning. The disparity between the patient's self-estimate and self-measurement and the clinician's assessment of the patient's facial functioning raises doubts about the validity of subjective reports and assessment. Conclusions. The present study supports the use of generic QOL measures to assess outcome and to draw comparisons between different populations.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Christina L Wassel ◽  
Matthew A Allison ◽  
Joachim H Ix ◽  
Julie O Denenberg ◽  
Dena E Rifkin ◽  
...  

Background: Lower extremity peripheral artery disease (PAD) affects approximately 9 million people in the US. Less well-recognized is that PAD, even when asymptomatic, is associated with decreased functional status and quality of life. Previous studies have largely examined associations of the ankle brachial index (ABI) and quality of life in participants with PAD. To our knowledge no studies have examined the impact of ABI and change in ABI on change in quality of life in a population-based setting. Methods: The SDPS is a population-based prospective study that evaluated non-Hispanic White, African-American, Hispanic and Asian men and women for lower extremity PAD at two examinations approximately 11 years apart. Participants completed the SF-36 questionnaire, and 802 participants had ABI and SF-36 data available at both examinations. Analyses were restricted to these participants who also had a baseline ABI<1.4. Growth curve models were used to assess the associations of baseline ABI and change in the ABI with change in the SF-36 physical component score (PCS) and mental component score (MCS) over time. Change in the ABI was defined as (follow-up ABI - baseline ABI)/baseline ABI. Results: Participants were on average 57±9 years of age at baseline, and 69±9 at follow-up. At baseline, nearly 2 percent had ABI≤0.90, and the mean±SD ABI was 1.12±0.10. After adjustment for age, sex, race/ethnicity, BMI, ever smoking, physical activity, hypertension, diabetes, and dyslipidemia, each SD lower baseline ABI was significantly associated with an average change of -0.63 points (95% CI (-0.10, -1.17), p=0.02) on the PCS. This association was marginally significant for the MCS (-0.54 points (0.14, 1.22), p=0.12). Lower baseline ABI was also associated with negative change in two SF-36 subscales, physical functioning (p=0.02) and vitality (p=0.01). Change in the ABI over 11 years was not associated with change in the MCS (p=0.97) or PCS (p=0.41). Results were similar when excluding participants with ABI≤0.90. Conclusions: A lower ABI at baseline is associated with a significantly worse physical functioning quality of life approximately 11 years later. However change in the ABI was not significantly associated with change in quality of life over this time period. Additional studies are warranted in larger samples, especially to confirm the lack of findings for change in ABI.


2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii12-ii13
Author(s):  
S M Keshwara ◽  
A I Islim ◽  
C P Millward ◽  
C S Gillespie ◽  
G E Richardson ◽  
...  

Abstract BACKGROUND Long-term Health-Related Quality of Life (HRQoL) is an important measure of patient wellbeing. There is a paucity of studies evaluating HRQoL in meningioma patients. MATERIAL AND METHODS Cross-sectional study of adult patients with an incidental or symptomatic intracranial meningioma. Patients with less than 5 years of follow-up, a history of craniospinal radiation or neurofibromatosis type 2 were excluded. HRQoL was evaluated with SF-36, EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires. Outcome determinants were evaluated using a multi-variable linear regression analysis, adjusted for patient, tumour and treatment characteristics, and duration of follow-up. RESULTS 699 patients were invited to participate and 246 responded: 118 (48%) had an incidental meningioma. Mean age at diagnosis was 56.8 years (SD=13) and 81% were female. Median time from diagnosis to completion of questionnaire was 8.5 years (IQR 6.8–11.5). During follow-up, 158 patients (64.2%) had at least one operation for their meningioma and 47 patients (19.1%) had radiotherapy. Of those operated, 126 (79.7%) had WHO grade 1 and 24 (15.2%) had grade 2 meningiomas. Compared to normative population values, meningioma patients reported a worse SF-36 general health score (mean 61.9 vs 56.5, P=0.003) but a similar QLQ-C30 global health score (mean 62.3 vs 65.8, P=0.039), worse SF-36 and QLQ-C30 physical functioning scores (mean 74.1 vs 64.6, P&lt;0.001 and mean 81.8 vs 76.5, P=0.007) and similar SF-36 and QLQ-C30 emotional health scores (mean 72.2 vs 70.9, P=0.367 and mean 71.0 vs 71.9, P=0.960). QLQ-C30 cognitive functioning was worse (mean 80.5 vs 71.4, P&lt;0.001). Compared to the meningioma literature, QLQ-BN20 seizure burden was similar (mean 2.0 vs 1.6, P=0.760). A worse performance status at diagnosis was associated with an inferior QLQ-C30 global health score (β-coefficient=-4.9 [95% CI -9.1-(-)0.6] P=0.024). Number of surgeries was significantly associated with a worse QLQ-C30 cognitive functioning score (β-coefficient=-7.0 [95% CI -13.2-(-)0.9], P=0.025). Anti-epileptic drug use was associated with a significantly worse QLQ-C30 emotional health score (β-coefficient=-10.9 [95% CI -21.7-(-)0.01], P=0.050). CONCLUSION Meningioma patients have long-term HRQoL impairments affecting their physical and cognitive functions. An understanding that multiple surgeries affects cognitive function, and the need for anti-epileptic drugs equate to poorer emotional health, could help target appropriate therapies and support in the future.


Sign in / Sign up

Export Citation Format

Share Document