Gesundheitsbezogene Lebensqualität nach Polytrauma

Health-related quality of life after polytrauma

by Feros Bator
Doctoral thesis
Date of Examination:2024-11-28
Date of issue:2024-11-12
Advisor:PD Dr. Christopher Spering
Referee:PD Dr. Christopher Spering
Referee:Prof. Dr. Nicole von Steinbüchel-Rheinwall
Persistent Address: http://dx.doi.org/10.53846/goediss-10846

 

 

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Abstract

English

Introduction Polytrauma is the leading cause of mortality and long-term disability among children and young adults. Advances in polytrauma management over the last decades have significantly improved survival rates. Recently, the focus in polytrauma care has shifted toward understanding the impact of polytrauma on health-related quality of life (HRQoL), mental health, and socioeconomic outcomes. This study examined the HRQoL after polytrauma, aiming to identify and assess influencing factors to discuss potential strategies for improving long-term outcomes. Methods Seventy polytrauma patients who met inclusion criteria were surveyed. Four assessment tools (SF-36, PHQ-9, GAD-7, and a trauma-specific questionnaire) were used to evaluate HRQoL, depressive disorders (PHQ-9), anxiety disorders (GAD-7), and socioeconomic and trauma-specific changes. Univariate analysis and significance testing (t-tests, Wilcoxon-Mann-Whitney tests, Kruskal-Wallis tests, and Spearman’s rank correlation) were conducted. Results HRQoL was found to be significantly lower across all SF-36 dimensions compared to population norms (p < 0.001–0.0043). PHQ-9 and GAD-7 results indicated a higher prevalence of depressive and anxiety disorders in the patient cohort compared to population norms. Further analysis examined the influence of various factors on HRQoL using the SF-36’s Physical Health Score (PHS) and Mental Health Score (MHS). Pain, particularly in the lower extremities (PHS p = 0.004, MHS p = 0.001) and spine (PHS p = 0.044), was strongly associated with reduced physical and mental health. Socioeconomic disruptions, including partnership changes (p = 0.011), social losses (p = 0.022), job loss (p = 0.014), and financial strain (p = 0.026), were linked to declines in mental health. Physical and mental health were further compromised when daily activities were limited by injury sequelae (p < 0.001). Conclusion This study demonstrates that polytrauma leads to significant, long-term reductions in HRQoL, influenced by both injury-related and psychosocial factors. These findings highlight the need for individualized, interdisciplinary care approaches to prevent chronic health impacts and support comprehensive rehabilitation and reintegration for patients.
Keywords: Polytrauma; HRQoL; health-related quality of life; socioeconomic outcomes; mental health