From: Assessment of pre-injury health-related quality of life: a systematic review
Author, year, country | Instrument | Pre-injury HRQL | Post-injury HRQL | Change | Findings |
---|---|---|---|---|---|
Post-injury vs pre-injury | |||||
General injury | |||||
Brussoni, 2013, Canada [31] | EQ-5D | Not admitted: 0.97 1-3d: 0.94 4 + d: 0.93 | Not admitted: 0.90 1-3d: 0.76 4 + d: 0.61 | Not admitted: −0.07 1-3d: −0.18 4 + d: −0.32 | All categories of length of stay in hospital had significantly lower HRQL at follow-up than at baseline |
Ulvik, 2008, Norway [42] | EQ-5D | 0.97 | 0.70 | −0.27a | Significant decrease in HRQL in all dimensions |
Wilson, 2012, New Zealand [8] | EQ-5D | 0.94 | 5 m: 0.75 12 m: 0.78 | 5 m: −0.19 12 m: −0.16 | Significantly higher pre-injury HRQL than New Zealand norms. Recovered had significantly higher post-injury HRQL than norms. Non-recovered had significantly lower HRQL than norms. |
Watson, 2005, Australia [29] | SF-36 | PCS 55; MCS 55 | 1w: PCS 25; MCS 46 6w: PCS 34; MCS 53 12w: PCS 38; MCS 55 26w: PCS 43; MCS 52 52w: PCS 44; MCS 52 | 1w: PCS −30; MCS −9 6w: PCS −21; MCS −2 12w: PCS −17; MCS 0 26w: PCS −12; MCS −3 52w: PCS −11; MCS −3 | Consistently higher pre-injury scores than Australian norms. Males had higher pre-injury PCS and MCS than females. 18-24y and 65-74y had highest pre-injury MCS. Those with pre-injury paid-employment had significantly higher pre-injury PCS than those without. |
Innocenti, 2015, Italy [43] | SF-12 | PCS 53 (7), 24–64 MCS 55 (7), 28-63 | 6 m: PCS 41 (12), 14–64 6 m: MCS 46 (13), 16-67 | PCS −12a MCS −9a | 93% pre-injury PCS and MCS in normal range according to Italian norms. Significant worse HRQL after 6 m. |
Traumatic brain injury | |||||
Gross, 2012, Switzerland [44] | EQ-5D SF-36 | TBI: 99 (4); no TBI: 95 (14) TBI PCS 57 (6); MCS 50 (11) no TBI PCS 56 (7); MCS 51 (12) | TBI: 65 (28); no TBI: 76 (21) TBI - PCS: 44 (12); MCS: 39 (13) no TBI - PCS: 45 (11); MCS: 48 (13) | TBI: −34; no TBI: −19 TBI PCS −13; MCS −11 no TBI PCS −11; MCS −3 | TBI had significantly worse HRQL compared with no TBI (on EQ VAS, EQ-5D, MCS, but not on PCS) |
Ponsford, 2011, Australia [27] | SF-36 | mTBI PCS 54 (6); MCS 49 (8) no TBI PCS 54 (6); MCS 53 (7) | 1w: mTBI PCS: 38 (10); MCS: 44 (11) 1w: no TBI PCS:36 (10); MCS: 49 (11) 3 m: mTBI PCS: 52 (9); MCS: 48 (10) 3 m: no TBI PCS: 50 (9); MCS: 53 (7) | 1w: mTBI PCS: −16; MCS: −5 1w: no TBI PCS: −18; MCS: −4 3 m: mTBI PCS: −2; MCS: −1 3 m: no TBI PCS: −4; MCS: 0 | mTBI had significantly poorer mental HRQL pre-injury. Significant change in PCS in mTBI and no TBI, MCS only in mTBI. Scores dropped dramatically at 1w, returned to pre-injury levels at 3 m. |
Jimenez, 2013, US [22] | PedsQL | NHW: 86 Hispanic: 90 | NR | 0-3 m: NHW −5; Hispanic −16 0-12 m: NHW −5; Hispanic −13 0-24 m: NHW −5; Hispanic −13 0-36 m: NHW −5; Hispanic −16 | Pre-injury scores were higher for Hispanic than NHW. Post-injury scores were significantly lower for Hispanic compared with NHW. |
Pieper, 2014, US [25] | PedsQL | mTBI: 82 (13) no TBI: 81 (14) | mTBI: 82 (15) no TBI: 82 (16) | mTBI 0 no TBI: 1 | No significant differences were identified among mTBI, NBI, and uninjured groups. Cognitive HRQL after mTBI trended lower from 3–12 months post-injury. |
Hip fracture | |||||
 Beaupre, 2012, Canada [30] | EQ-5D | 0.62 (0.20) Survived 0.63 (0.20) Deceased 0.61 (0.20) | Survivors 3 m: 0.42 (0.25) 6 m: 0.46 (0.24) 12 m: 0.42 (0.30) | 3 m: −0.21 6 m: −0.17 12 m: −0.21 | At 1y, those alive had higher pre-injury HRQL than those that died. Significant loss in HRQL at 3 m that remained relatively unchanged 6 m and 12 m postoperatively. |
 Buecking, 2014, Germany [35] | EQ-5D | 0.71 | Discharge: 0.46 | Discharge: −0.25 | Significantly reduced HRQL during hospitalization. |
 Griffin, 2015, UK [36] | EQ-5Db | 0.56 | 4w: 0.28 4 m: 0.32 12 m: 0.36 | 4w: −0.28 4 m: −0.24 12 m: −0.2 | Significantly lower HRQL at one year than pre-injury. HRQL significantly improved after 4w in those aged ≤80y, but not in >80y. |
 Hagino, 2009, Japan [37] | EQ-5D | 0.80 (0.17) | 2w: 0.37 (0.27) 3 m: 0.64 (0.16) 6 m: 0.63 (0.18) 12 m: 0.68 (0.24) |  | Hip fracture had lower pre-injury HRQL than wrist facture (significant) or vertebral fracture. |
 Sugeno, 2008, Japan [38] | EQ-5D | 0.77 (0.24) | Discharge: 0.67 (0.21) 12 m: 0.81 (0.17) | Discharge: −0.10 12 m: 0.04 | HRQL decreased post-injury, but recovered to pre-facture levels 1y following hospitalization. |
 Tidermark, 2002, Sweden [39] | EQ-5D | 0.78 (0.21) Survived 0.79 (0.21) Deceased 0.73 (0.22) | Survivors 1w: 0.44 (0.33) 4 m: 0.55 (0.37) 12 m: 0.51 (0.36) | 1w: −0.34 4 m: −0.23 12 m: −0.27 | Similar pre-injury HRQL compared to Swedish population norms. Decrease in HRQL from pre- to post-injury. Patients did not regain their pre-injury HRQL. |
 Jaglal, 2000, Canada [34] | SF-36 | PF 74 (24); RP 68 (46); BP 92 (16); GH 79 (20); VT 63 (22); SF 86 (21); RE 86 (34); MH 73 (20) | 6w: PF 44 (18); RP 2 (7); BP 68 (20); GH 75 (19); VT 54 (18); SF 75 (23); RE 85 (36); MH 79 (16) 6 m: PF 59 (22); RP 63 (48); BP 78 (24); GH 77 (25); VT 59 (23); SF 77 (25); RE 96 (21); MH 82 (13) | 6w: PF −30a; RP −66a; BP −24a; GH −4; VT −9; SF −11a; RE −1a; MH 6 6 m: PF −15a; RP −5a; BP −14a; GH −2; VT −4; SF −9; RE 10; MH 9a | Significant decrease in HRQL from pre- to post-injury in all domains (ex GH, VT, MH). Significantly lower PF, RP, BP but higher MH at 6 m than pre-injury. |
 Peterson, 2008, US [24] | SF-36 | Survived PF 56 (36); RP 81 (33); BP 84 (24); GH 75 (21); VT 65 (22); SF 86 (23); RE 93 (26); MH 76 (20) Died PF 41 (29); RP 60 (43); BP: 82 (24); GH 62 (26); VT 55 (23); SF 84 (24); RE 85 (32); MH 79 (22) | NA |  | At recruitment, no differences in domain scores between those living at 5 years and those dead (though small N, large SD). At 5y, significantly higher PF, RP and GH in those alive than those that died. |
Extremity injury | |||||
  Ding, 2006, US [19] (Extremity) | PedSQL | 89 | 3 m: 73 12 m: 80 | 3 m: −16 12 m: −9 | Similar pre-injury HRQL for upper- and lower- extremity fractures. Significantly lower HRQL post-injury than pre-injury. |
 Busse, 2012, Canada [32] (Tibia) | SF-36 | PCS 53 (9) MCS 54 (9) | 2w: PCS 28 (8); MCS 46 (13) 12 m: PCS 43 (11); MCS 52 (12) | 2w: PCS −25; MCS −8 12 m: PCS −10; MCS −2 | Decrease in HRQL from pre- to post-injury. Patients did not regain their pre-injury HRQL. |
 Skoog, 2001, Sweden [40] (Tibia) | SF-36b | PF 72; RP 83; BP 80; GH 80; VT 75; SF 83; RE 88; MH 82 | 4 m: PF 60; RP 45; BP 63; GH 74; VT 62; SF 70; RE 58; MH 77 12 m: PF 68; RP 58; BP 66; GH 70; VT 57; SF 70; RE 76; MH 73 | 4 m: PF −12a; RP −38a; BP −17; GH −6; VT −13; SF −13a; RE −30a; MH −5 12 m: PF −4; RP −25; BP −14a; GH −10a; VT −18a; SF −13; RE −12; MH −9 | Pre-injury HRQL was comparable to Swedish healthy population. SF-36 domain scores were lower at 4 m and 12 m, compared to pre-injury HRQL. |
 Lyrtzis, 2012, Greece [41] (Ankle) | SF-36 | 89 (6); 68–97 PF 96; RP 95; BP 91; GH 76; VT 79; SF 92; RE 93; MH 87 | 10d: 68 (11); 52–82 PF: 64; RP: 72; BP: 71; GH: 54; VT: 78; SF: 77; RE: 82; MH: 68 | 10d: −21 PF −32; RP −23; BP −20; GH −22; VT −1; SF −15; RE −11; MH −19 | Significant worsening of HRQL 10d after injury, compared to pre-injury HRQL. |
 McGuine, 2014, US [23] (Knee) | SF-12 | PCS 56 (5) MCS 56 (7) | Diagnosis: PCS 41 (11); MCS 51 (12) 3 m: PCS 48 (9); MCS 53 (10) 6 m: PCS 53 (7); MCS 53 (9) 12 m: PCS 54 (6); MCS 54 (8) | Diagnosis: PCS −15; MCS −5 3 m: PCS −8; MCS −3 6 m: PCS −3; MCS −3 12 m: PCS −2; MCS −2 | Pre-injury HRQL was higher than population norms in all domains. HRQL change from preinjury through an entire 12 m after injury. |
 Hagino, 2009, Japan [37] (Wrist) | EQ-5D | 0.93 (0.13) | 2w: 0.72 (0.14) 3 m: 0.81 (0.18) 6 m: 0.87 (0.15) 12 m: 0.88 (0.15) | 2w: −0.21 3 m: −0.12 6 m: −0.06 12 m: −0.05 | Hip fracture had lower pre-injury HRQL than wrist facture (significant) or vertebral fracture. Scores showed recovery after 6 m. After 1y, scores were not significantly different from pre-fracture. |
Other injury | |||||
  Pons-Villanueva, 2011, Spain [46] (MVC) | SF-36 | MVC PCS 53; MCS 47 PF 95; RP 87; BP 74; GH 73; VT 65; SF 89; RE 80; MH 71 No MVC PCS 53; MCS 49 PF 95; RP 91; BP 79; GH 76; VT 66; SF 92; RE 87; MH 76 | MVC PCS 51; MCS 48 PF 93; RP 83; BP 69; GH 71; VT 63; SF 91; RE 82; MH 73 No MVC PCS 53; MCS 50 PF 95; RP 92; BP 78; GH 77; VT 66; SF 94; RE 90; MH 77 | MVC PCS −2; MCS 1 PF −2; RP −4; BP −5; GH −2; VT −2; SF −2; RE 2; MH 2 No MVC - PCS 0; MCS 1 PF 0; RP 1; BP −1; GH 1; VT 0; SF 2; RE 3; MH 1 | All physical scales declined in participants reporting a MVC, while mental health dimensions increased. Patients who did not have any MVC had significantly higher HRQL than those who suffered a MVC on RP, BP, GH, RE, MH, MCS and PCS. |
  Alghnam, 2014, US [18] (MVC) | SF-12 | MVC PCS 50; MCS 49 No MVC PCS 50; MCS 51 | MVC PCS 47; MCS 49 No MVC PCS 50; MCS 51 | MVC PCS −3; MCS 0 No MVC PCS 0; MCS 0 | Similar baseline PCS in MVC and no MVC. Significant lower baseline MCS in MVC than no MVC. |
 Ottosson, 2007, Sweden [45] (Muscosk) | SF-36b | Recovered 1 m: PF 93; RP 93; BP 92; GH 85; VT 75; SF 92; RE 94; MH 85 Not recovered: PF 85; RP 83; BP 80; GH 83; VT 73; SF 91; RE 83; MH 85 | 1 m: Rec 1 m PF 95; RP 93; BP 89; GH 85; VT 73; SF 95; RE 93; MH 85 No rec PF 63; RP 30; BP 43; GH 68; VT 45; SF 68; RE 85; MH 67 6 m: No rec PF 70; RP 45; BP 53; GH 65; VT 51; SF 76; RE 60; MH 70 | 1 m: Rec 1 m PF 2; RP 0; BP −3; GH 0; VT −2; SF 3; RE −1; MH 0 No rec PF −22; RP −53; BP −37; GH −15; VT −28; SF −23; RE −30; MH −18 6 m: No rec PF −15; RP −38; BP −27; GH −18; VT −22; SF −15; RE −23; MH −15 | Pre-injury HRQL was comparable to Swedish norm population. At 1 m patients who reported no recovery had significantly lower scores on all domains, compared to those reporting recovery. |
 Andrew, 2012, Australia [26] (Ortho) | SF-36 | PCS 59 (4); MCS 55 (7) PF 57 (3); RP 56 (4); BP 60 (6); GH 60 (6); VT 60 (8); SF 56 (5); RE 55 (5); MH 55 (7) | PCS 52 (10); MCS 53 (10) PF 52 (8); RP 50 (10); BP 52 (10); GH 55 (10); VT 52 (10); SF 52 (10); RE 53 (7); MH 52 (9) | PCS −7; MCS −2 PF −5; RP −6; BP −7; GH −5; VT −7; SF −4; RE −2; MH −3 | Significant reductions in all SF-36 subscale scores, with RP and BP reporting the most reductions. |
 Gabbe, 2007, Australia [6] (Ortho) | SF-12 | PCS 51; Men 53; Women 48 MCS 55; Men 55; Women 54 | NA |  | Significantly higher PCS (stratified men 25-54y) and MCS (men 18-24y, women 18-24y, 25-34y or 45-54y) than Australian norms. |
 Dvorak, 2005, Canada [33] (Spine) | SF-36 | PCS 49 (13) MCS 52 (10) | PCS 43 (13) MCS 49 (14) | PCS −6 MCS −3 | No significant differences between patients’ recalled PCS and MCS and Canadian norms. |
 Hagino, 2009, Japan [37] (Spine) | EQ-5D | 0.88 (0.17) | 2w: 0.53 (0.17) 3 m: 0.76 (0.18) 6 m: 0.75 (0.16) 12 m: 0.84 (0.17) | 2w: −0.35 3 m: −0.12 6 m: −0.13 12 m: −0.04 | Hip fracture had lower pre-injury HRQL than wrist (significant) or vertebral fracture. Scores at 6 m were significantly lower than pre-injury. After 1y, scores were not significantly different from pre-fracture values. |
 Fauerbach, 1999, US [20] (Burn) | SF-36 | PTD PF 87 (24); RP 85 (34); BP 87 (28); GH 77 (25); VT 66 (20); SF 88 (24); RE 85 (32); MH 77 (14) No PTD PF: 92 (20); RP 91 (22); BP 81 (30); GH 87 (11); VT: 73 (20); SF 94 (19); RE 97 (16); MH 88 (9) | 2 m: PTD PF 66 (27); RP 29 (39); BP 41 (19); GH 68 (24); VT 52 (24); SF 75 (30); RE 76 (38); MH 67 (22) No PTD PF 85 (22); RP 56 (49); BP 47 (21); GH 83 (15); VT 69 (23); SF 92 (18); RE 92 (34); MH 87 (12) | 2 m: PTD PF −21; RP −56; BP −46; GH −9; VT −14; SF −13; RE −9; MH −10 No PTD PF −7; RP −35; BP −34; GH −4; VT −4; SF −2; RE −5; MH −1 | Higher pre-injury HRQL in PTD (BP) and non-PTD (MH, VT, RE, SF, GH) than US norms. |
 Wasiak, 2014, Australia [28] (Burn) | SF-36 | PCS 56 (9) MCS 52 (12) | PCS 52 (13) MCS 52 (11) | PCS −4 (1) MCS 0 (1) | Pre-burn PCS was higher than Australian norms, MCS was comparable. HRQL at 12 m were consistent with the Australian norms. Significant lower PCS at 12 m compared with pre-injury. |
 Greenspan, 2002, US [21] (Gunshot) | SF-36 | PF 96 (14); RP 89 (29); BP 93 (19); GH 85 (20); VT 70 (21); SF 86 (27); RE 83 (34); MH 76 (24) | 8 m: PF 71 (28); RP 43 (42); BP 63 (32); GH 58 (27); VT 52 (28); SF 67 (31); RE 64 (43); MH 68 (25) | PF −25; RP −46; BP −30; GH −27; VT −18; SF −19; RE −19; MH −8 | Pre-injury scores were similar to population norms, except for PF and GH (higher). Significant declines in PCS and MCS, and across all domains compared to pre-injury (especially PF, RP, BP, GH, and VT). |