scholarly journals The Effect of Pre-Trauma Alcohol Use on Post-Traumatic Quality of Life in Severely Injured Trauma Patients

2020 ◽  
Author(s):  
Antti Ilmari Riuttanen ◽  
Jarkko Jokihaara ◽  
Tuomas T. Huttunen ◽  
Ville M. Mattila
Keyword(s):  
Quality Of Life ◽  
Alcohol Use ◽  
Relative Number ◽  
Reference Population ◽  
Anxiety And Depression ◽  
Trauma Patients ◽  
Post Injury ◽  
One Year ◽  
Population Norm

Abstract Background From one third up to half of all injured patients admitted to emergency rooms have a positive blood alcohol level (BAL). Frequent alcohol use also has negative effects on a person’s quality of life. Even though alcohol use among injury patients is common, the effects of pre-injury alcohol use on Health-Related Quality of Life (HR-QoL) have not previously been studied. The primary objective of this study was to evaluate whether pre-injury alcohol use has an influence on an injured patient’s HR-QoL and reported problems. A secondary objective was to compare injured patient’s HR-QoL with the population norm of Finland. Methods Retrospective analysis of all trauma patients treated at Tampere University Hospital’s (TAUH) Intensive Care Unit (ICU) or High Dependence Unit (HDU) in 2013. The following inclusion criteria were used: patient treated at TAUH’s ICU or HDU, age ≥ 18 years, NISS ≥ 16 and possesses a valid Finnish personal identification number to enable comprehensive follow-up. From a total of 373 patients, 227 patients met the inclusion criteria. HR-QoL was assessed with the EQ-5D questionnaire during the patients’ stay in the ICU/HDU and one year after the injury. The EQ-5D index value was further compared with the index values of the age-matched population norms of Finland. Results Thirty-four percent (77/227) of all patients tested positive for alcohol at the time of the injury with a mean blood alcohol content (BAC) of 1.9 g/L. Twenty-nine patients (N= 29/227) died within 1 year of injury, and therefore 198 patients were contacted for post-injury EQ-5D questionnaires. Complete data sets with both pre- and post-injury EQ-5D questionnaires were available for 111 (56%) patients. Patients with positive BAL expressed notably more anxiety and depression (45%) before trauma compared to both patients with negative BAL (11%) and the reference population of Finland (14%). Overall, pre-injury HR-QoL was also poorer in BAL positive patients than BAL negative patients. The amount of anxiety and depression in BAL positive patients decreased after injury. In both groups, the relative number of reported problems after injury exceeded the relative number of reported problems of the reference population of Finland in all five EQ-5D dimensions. Conclusions Patients with positive BAL upon admission report overall lower HR-QoL than patients with negative BAL. This finding is most likely explained by the excessive amount of anxiety and depression, which had decreased one year after injury. We speculate that this may partly be explained by a possible reduction in alcohol use, which has been reported to happen in injury patients. As has previously been reported, the impact of severe injury on post-injury QoL in general is detrimental and long-lasting and overall HR-QoL remains lower than the population norm.

scholarly journals Health-Related Quality of Life in Severely Injured Trauma Patients with Positive and Negative Blood Alcohol Level on Admission

2020 ◽  
Author(s):  
Antti Riuttanen ◽  
Jarkko Jokihaara ◽  
Tuomas T. Huttunen ◽  
Ville M. Mattila
Keyword(s):  
Alcohol Use ◽  
Relative Number ◽  
Reference Population ◽  
Anxiety And Depression ◽  
Trauma Patients ◽  
Severely Injured ◽  
Post Injury ◽  
Related Quality ◽  
Negative Effect ◽  
The Impact

Abstract PurposeThe objectives of this study were to evaluate whether pre-injury alcohol use has an influence on an injured patient’s HR-QoL and reported problems.MethodsRetrospective analysis of 227 severely injured trauma patients (age ≥ 18 years, NISS ≥ 16) treated at Tampere University Hospital’s (TAUH) Intensive Care Unit (ICU) or High Dependence Unit (HDU) in 2013. HR-QoL was assessed with the EQ-5D questionnaire, and was further compared with index values of population norms of Finland.ResultsPatients with positive BAL expressed notably more anxiety and depression (45%) before trauma compared to both patients with negative BAL (11%) and the reference population (14%). Overall, pre-injury HR-QoL was also poorer in BAL positive patients than BAL negative patients. The amount of anxiety and depression in BAL positive patients decreased after injury. In both groups, the relative number of reported problems after injury exceeded the relative number of reported problems of the reference population in all five EQ-5D dimensions.ConclusionsPatients with positive BAL upon admission report overall lower pre-injury HR-QoL than patients with negative BAL, which is most likely explained by the alcohol’s negative effect on mental health. As reported anxiety and depression decreased one year after injury, we speculate that this may partly be explained by a possible reduction in alcohol use, which has been reported to happen in injury patients. As has previously been reported, the impact of severe injury on post-injury QoL in general is detrimental and long-lasting and overall HR-QoL remains lower than the population norm.

scholarly journals Depresión, ansiedad y salud autopercibida en estudiantes de Medicina: un estudio transversal.

2021 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Iván Gutiérrez Pastor ◽  
Jose Antonio Quesada Rico ◽  
Aarón Gutiérrez Pastor ◽  
Rauf Nouni García ◽  
María Concepción Carratalá Munuera
Keyword(s):  
Quality Of Life ◽  
Medical Students ◽  
Alcohol Use ◽  
Alcohol Use Disorders ◽  
Perceived Health ◽  
Anxiety And Depression ◽  
Identification Test ◽  
Academic Year ◽  
De Medicina

La salud mental de estudiantes universitarios es un motivo de investigación a nivel internacional. El objetivo de este estudio fue estimar la prevalencia de ansiedad, depresión y estado de salud autopercibida de los estudiantes de medicina de la Universidad Miguel Hernández y analizar su asociación con diferentes variables sociodemográficas y del estilo de vida. Para ello, se realizó un estudio descriptivo transversal de estudiantes de medicina de 1º a 6º curso de la Universidad Miguel Hernández de Elche durante el curso 2019-20. Se utilizaron la Escala Visual Analógica (EVA) del European Quality of Life-5 Dimensions (EQ-5D), la Escala de Ansiedad y Depresión de Goldberg (EADG), el estudio Prevención con Dieta Mediterránea (PREDIMED), el Alcohol Use Disorders Identification Test (AUDIT-C) y el Test de Fagerström. Todos los cuestionarios están validados en España. Para el análisis se ajustaron modelos logísticos multivariantes. Fueron encuestados 474 estudiantes. La tasa de respuesta global fue del 55.26%. Un 68.1% de la muestra eran mujeres. Se estimó una prevalencia de probable ansiedad del 54.9%, probable depresión del 60.9% y probable ansiedad o depresión del 73.3%. La salud autopercibida regular-mala-muy mala fue del 8.9%. Se detectó una asociación estadísticamente significativa con el sexo, la edad, el curso académico, el municipio de residencia, el tipo de alimentación, la actividad física y el consumo de tóxicos. Como conclusión, los estudiantes de medicina de la Universidad Miguel Hernández presentaron una prevalencia alta de probable ansiedad y depresión. Se observaron diferencias en función del sexo, curso académico, tipo de alimentación y consumo de tóxicos. The mental health of university students is a reason for international research. The objective of this study was to estimate the prevalence of anxiety, depression and self-perceived health status of medical students from the Miguel Hernandez University and analyze their association with different sociodemographic and lifestyle variables. We did a cross-sectional descriptive study of medical students from 1st to 6th year of the Miguel Hernandez University during the 2019-20 academic year. They were used the Visual Analogue Scale (VAS) of the European Quality of Life-5 Dimensions (EQ-5D), the Goldberg Anxiety and Depression Scale (GADS), the Mediterranean Diet Prevention study (PREDIMED), the Alcohol Use Disorders Identification Test (AUDIT-C) and the Fagerström Test were used. All the questionnaires are validated in Spain. For the analysis, multivariate logistic models were adjusted. They were surveyed 474 students. The overall response rate was 55.26%. 68.1% of the sample were women. A prevalence of probable anxiety of 54.9%; probable depression of 60.9% and probable anxiety or depression of 73.3% was estimated. Regular-bad-very bad self-perceived health was only 8.9%. A statistically significant association was detected between the aforementioned variables and sex, age, academic year, municipality of residence, type of diet, physical activity and consumption of toxics. The medical students of the Miguel Hernandez University presented a high prevalence of probable anxiety and depression. Differences were observed based on sex, academic year, type of diet and consumption of toxic drugs.

Immune Reconstitution and Quality of Life Analyses After Autologous Transplant for Multiple Myeloma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4460-4460
Author(s):  
Craig C. Hofmeister ◽  
Mindy A Bowers ◽  
Anissa Bingman ◽  
Gerard Lozanski ◽  
Robert A. Baiocchi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
T Cells ◽  
Nk Cells ◽  
Peripheral Blood ◽  
Nk Cell ◽  
Anxiety And Depression ◽  
Time To Progression ◽  
Post Transplant ◽  
One Year

Abstract Abstract 4460 Introduction: Multiple myeloma patients after autologous hematopoietic stem cell transplant (HSCT) achieve a minimal residual disease state, providing an opportunity for immunomodulatory therapy – but the details of immune recovery after transplant are not clear. Early lymphocyte recovery is associated with improved overall survival (Porrata et al, 2003) which is thought to be related to NK cell recovery. Myeloma patients with long term disease control have recovered circulating B-cells, bone marrow dendritic cells and tissue macrophages similar to healthy adults, but have few circulating regulatory T-cells (Pessoa et al, Haematologica, 2012). Methods: This trial assessed immune function as measured by response to the conjugate vaccine to Streptococcus pneumoniae (Prevnar, PCV7), detailed peripheral blood lymphocyte subset analysis (including NK cell subsets and Tregs), as well as quality of life measures (Hospital Anxiety and Depression Scale, Brief Fatigue Inventory [BFI], Brief Pain Inventory [BPI], and the FACT-G) after autologous transplant for myeloma. Myeloma patients after either 140 or 200 mg/m2 melphalan HSCT were enrolled if they had ANC ≥1000/μL, platelet count ≥ 75,000/μL, and adequate hepatic function by the time Prevnar [serotypes 4, 9V, 14, 18C, 19F, 23F, and 6B] was administered on weeks 9 [month 2], 17 [month 4], and 25 [month 6] after autologous HSCT. Maintenance therapy was an exclusion criteria. Results: Thirty patients were enrolled – twelve with ISS stage 1 at diagnosis, six with ISS 2, five patients with ISS 3, and nine were unknown. Disease status pre-transplant revealed 34% CR and 78% ≥PR, at +60 days 44% CR and 94% ≥PR, but by +180 days the ≥PR was down to 76% due primarily to relapses from CR. With a median follow-up of 35 months since diagnosis and 28 months since transplant, median time to progression has not been reached. We used ELISA to assess antibody concentration against immunogenic antigens (14 & 18c) and the less immunogenic antigen 23F. Two months after each PCV7 injection [weeks 13, 25, and 33], an adequate response (>35 mcg/mL) was demonstrated for antigen 14 in 7% (2/29) at week 13, 16% (4/25) at week 25, and 19% (5/27) at week 33. For antigen 18C, 6.7% (2/30) at week 13, 8.3% (2/24) at week 25, and Z% (4/26) at week 33. At one year responses faded with only 10% (2/20) for antigen 14, 0% (0/24) for antigen 18C, and 0% (0/7) for antigen 23F. Quality of life analyses including BFI, FACT-G, BPI, and HADS showed no significant changes from weeks 9, 17, 25, and off study except for worsening anxiety and depression at one year post-transplant compared to study entry. Peripheral blood flow cytometry using Cox univariate analysis showed an association with overall survival with late activated T-cells (CD3+HLA-DR+, p<0.05 at 30 days and p<0.01 at 100 days) and degranulated T-cells (CD3+CD63+,p<0.09 at 30 days, p<0.06 at 100 days. An association with the achievement of CR at day +30 post-transplant was seen for NK cells (CD3-CD16+CD56+, p<0.024), KIR- NK cells (CD3-CD16+CD56+CD158b-, p<0.07), and CD314+ NK-cells (CD3-CD16+CD56+CD314+, p<0.04. Calculating Spearman correlation coefficients between lymphocyte subsets and Prevnar antibody response found no lymphocyte subset associated with response in more than one antigen. Conclusions: In this pilot trial of 30 myeloma patients we have shown that the adaptive immune system is profoundly suppressed with a minority of patients reacting to the conjugate vaccine Prevnar. Depression and anxiety both worsen in the first year post transplant. Multivariate and grouped covariate analyses of peripheral blood lymphocyte subsets with both Prevnar response and time to progression will be presented at the meeting. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Psychological Differences of Patients and Relatives according to Post-Transplantation Anxiety

2008 ◽  
Vol 11 (1) ◽  
pp. 250-258 ◽  
Author(s):  
María Ángeles Pérez San Gregorio ◽  
Agustín Martín Rodríguez ◽  
José Pérez Bernal
Keyword(s):  
Quality Of Life ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Life Questionnaire ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Psychological Differences ◽  
One Year

The aim of this investigation is to analyze the psychological differences of patients and their relatives according to the formers' post-transplantation anxiety. We used two groups of participants: transplant patients (n = 166) and close relatives (n = 166). Four questionnaires were applied: a Psychological Survey (to both groups), the Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire (to the transplant patients), and the Leeds Scales for the Self-Assessment of Anxiety and Depression (to the relatives). Participants were assessed twice: post-Intensive Care Unit (ICU; when patients were moved from the ICU to the Transplantation Unit) and post-hospital (one year after transplant). Results showed that high anxiety in patients just after organ transplant was related to an increase of anxiety and depression symptoms both in patients and relatives one year after transplant; it was also related to a decrease in the quality of life of these patients.

Postoperative quality of life of patients treated for asymptomatic unruptured intracranial aneurysms

2007 ◽  
Vol 107 (6) ◽  
pp. 1086-1091 ◽  
Author(s):  
Shigeo Yamashiro ◽  
Toru Nishi ◽  
Kazunari Koga ◽  
Tomoaki Goto ◽  
Daisuke Muta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intracranial Aneurysms ◽  
Short Form ◽  
Reference Population ◽  
Anxiety And Depression ◽  
Unruptured Intracranial Aneurysms ◽  
Number Of Patients ◽  
Sf 36 ◽  
Risk Of Rupture

Object The aim of this study was to assess the quality of life (QOL) of patients who underwent surgery for asymptomatic unruptured intracranial aneurysms (UIAs). Methods The authors assessed QOL in 149 patients who had undergone microsurgical clipping of asymptomatic UIAs. They surveyed these patients using universal methods such as the 36-Item Short Form Health Survey (SF-36) for health-related QOL and the Hospital Anxiety and Depression Scale for anxiety and depression assessments. Results The patients' mean scores for each of the eight domains of SF-36 were comparable to those of a Japanese reference population. Analysis of data from the average-QOL and low-QOL subgroups showed that the low-QOL group contained a higher number of patients with preexisting heart diseases and restricted activities of daily living. Operative procedures and complications did not affect QOL. Conclusions Because 86% of the patients who underwent surgery manifested a QOL similar to the reference population, the authors suggest that elective surgery for asymptomatic UIAs is a reasonable treatment, especially in patients who are troubled by the risk of rupture. Postoperative decreases in QOL are not invariably attributable to the operation or its associated complications, but may be correlated with other chronic disorders. To select the appropriate treatment for asymptomatic UIAs, neurosurgeons and patients need information on the expected postoperative QOL.

Patient-reported outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses: Findings from the national DenHeart survey

2018 ◽  
Vol 26 (6) ◽  
pp. 624-637 ◽  
Author(s):  
Selina K Berg ◽  
Charlotte B Thorup ◽  
Britt Borregaard ◽  
Anne V Christensen ◽  
Lars Thrysoee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Discharge ◽  
Patient Reported Outcomes ◽  
Severe Symptom ◽  
Poor Quality ◽  
Anxiety And Depression ◽  
Cardiac Events ◽  
Patient Reported ◽  
One Year

Aims Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient-reported outcomes at hospital discharge as a predictor of mortality and cardiac events. Design A cross-sectional survey with register follow-up. Methods Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark. Main outcomes Patient-reported outcomes: anxiety and depression (Hospital Anxiety and Depression Scale); perceived health (Short Form-12); quality of life (HeartQoL and EQ-5D); symptom burden (Edmonton Symptom Assessment Scale). Register data: mortality and cardiac events within one year following discharge. Results There were 471 deaths among the 16,689 respondents in the first year after discharge. Across diagnostic groups, patients reporting symptoms of anxiety had a two-fold greater mortality risk when adjusted for age, sex, marital status, educational level, comorbidity, smoking, body mass index and alcohol intake (hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.52–2.42). Similar increased mortality risks were found for patients reporting symptoms of depression (HR 2.29, 95% CI 1.81–2.90), poor quality of life (HR 0.46, 95% CI 0.39–0.54) and severe symptom distress (HR 2.47, 95% CI 1.92–3.19). Cardiac events were predicted by poor quality of life (HR 0.71, 95% CI 0.65–0.77) and severe symptom distress (HR 1.58, 95% CI 1.35–1.85). Conclusions Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses.

scholarly journals Mapping Health-Related Quality of Life, Anxiety, and Depression in Patients with Head and Neck Cancer Diagnosed with Malnutrition Defined by GLIM

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1167
Author(s):  
Ylva Tiblom Ehrsson ◽  
Per Fransson ◽  
Sandra Einarsson
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Anxiety And Depression ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
One Year

Patients with cancer deal with problems related to physical, psychological, social, and emotional functions. The aim was to investigate malnutrition defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria in relation to health-related quality of life, anxiety, and depression in patients with head and neck cancer. This was a prospective observational research study with 273 patients followed at the start of treatment, seven weeks, and one year. Data collection included nutritional status and support, and the questionnaires: European Organization for Research and Treatment of Cancer Head and neck cancer module (EORTC QLQ-H&N35) and the Hospital Anxiety and Depression Scale (HADS). Malnutrition was defined using the GLIM criteria. The study showed that patients with malnutrition had significantly greater deterioration in their health-related quality of life at seven weeks. On a group level, health-related quality of life was most severe at this time point and some scores still implied problems at one year. Significantly, more patients reported anxiety at the start of treatment whereas significantly more patients reported depression at seven weeks. Over the trajectory of care, the need for support often varies. Psychosocial support is imperative and at the end of treatment extra focus should be put on nutritional interventions and managing treatment-related symptoms to improve nutritional status and health-related quality of life. In the long-term, head and neck cancer survivors need help to find strategies to cope with the remaining sequel.

scholarly journals Health-related quality of life one year after the diagnosis of oesophageal cancer: a population-based study from the Swedish National Registry for Oesophageal and Gastric Cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Berit Sunde ◽  
Mats Lindblad ◽  
Marlene Malmström ◽  
Jakob Hedberg ◽  
Pernilla Lagergren ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oesophageal Cancer ◽  
Reference Population ◽  
Population Based ◽  
National Registry ◽  
Palliative Intent ◽  
Related Quality ◽  
Health Related ◽  
One Year

Abstract Background Population-based patient reported outcome data in oesophageal cancer are rare. The main purpose of this study was to describe health-related quality of life (HRQOL) 1 year after the diagnosis of oesophageal cancer, comparing subgroups of curatively and palliatively managed patients. Methods This is a nationwide population-based cohort study, based on the Swedish National Registry for Oesophageal and Gastric Cancer (NREV) with prospectively registered data, including HRQOL instruments from the European Organisation for Research and Treatment of Cancer including the core and disease specific questionnaires (EORTC QLQ-C30 and QLQ-OG25). Patients diagnosed with oesophageal cancer between 2009 and 2016 and with complete HRQOL data at 1 year follow-up were included. HRQOL of included patients was compared to a reference population matched by age and gender to to a previous cohort of unselected Swedish oesophageal cancer patients. Linear regression was performed to calculate mean scores with 95% confidence intervals (CI) and adjusted linear regression analysis was used to calculate mean score differences (MD) with 95% CI. Results A total of 1156 patients were included. Functions and global health/quality of life were lower in both the curative and palliative cohorts compared to the reference population. Both curatively and palliatively managed patients reported a severe symptom burden compared to the reference population. Patients who underwent surgery reported more problems with diarrhoea compared to those treated with definitive chemoradiotherapy (dCRT) (MD -14; 95% CI − 20 to − 8). Dysphagia was more common in patiens treated with dCRT compared to surgically treated patients (MD 11; 95% CI 4 to 18). Those with palliative intent due to advanced tumour stage reported more problems with dysphagia compared to those with palliative intent due to frailty (MD -18; 95% CI − 33 to − 3). Conclusions One year after diagnosis both curative and palliative intent patients reported low function scores and severe symptoms. Dysphagia, choking, and other eating related problems were more pronounced in palliatively managed patients and in the curative intent patients treated with dCRT.

scholarly journals The Outcome of Unilateral Cochlear Implantation in Adults: Speech Recognition, Health-Related Quality of Life and Level of Anxiety and Depression: a One- and Three-Year Follow-Up Study

2019 ◽  
Vol 24 (03) ◽  
pp. e338-e346
Author(s):  
Pia Bergman ◽  
Björn Lyxell ◽  
Henrik Harder ◽  
Elina Mäki-Torkko
Keyword(s):  
Quality Of Life ◽  
Speech Recognition ◽  
Hearing Impairment ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
One Year

Abstract Introduction Hearing impairment is a common disease worldwide, with a comprehensive impact, and cochlear implantation (CI) is an intervention for profound hearing impairment. Objective To study the outcome one and three years after unilateral CI on hearing, health-related quality of life and level of depression and anxiety, and the correlation between the outcomes. Second, to study whether age, gender, etiology, operated side, residual hearing or cognitive performance can predict the outcome. Methods A prospective longitudinal study including adults with profound postlingual hearing impairment, with respect to hearing (speech recognition), health-related quality of life (Health Utilities Index 3) and level of depression and anxiety (Hospital Anxiety and Depression scale), pre-CI, and one and three years post-CI. The total sample was composed of 40 participants (40% of men), with a mean age of 71 years. Results Speech recognition and the overall health-related quality of life improved one year post-CI (p = 0.000), without correlation (ρ= 0.27), and with no difference three years post-CI. The hearing attribute (in the health-related quality of life instrument) improved one and three years post-CI (p = 0.000). The level of anxiety did not change one and three years post-CI. The level of depression improved one year post-CI (p = 0.036), and deteriorated three years post-CI (p = 0.031). Age, etiology, operated side, residual hearing and cognitive performance did not predict the outcome, but the female gender did significantly improve speech recognition compared with men (p = 0.009). Conclusion The CI significantly improved speech recognition, health-related quality of life and level of depression one year post-CI without mutual correlation, and women performed significantly better than men. There were no further improvements three years post-CI, apart from the hearing attribute.

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