title: Predicting Health-related Quality of Life of Severely Injured Patients: Sociodemographic, Economic, Trauma, and Hospital Stay-related Determinants.
abstract: BACKGROUND
  Due to remarkable improvements in emergency and intensive care medicine in the recent past, the mortality rate for severely injured patients is decreasing. Outcome research therefore should no longer focus only on questions of survival, but also on aspects of the quality of life after severe trauma. This study examined the long-term effect of different sociodemographic, economic, trauma, and hospital-related factors on the health-related quality of life (SF-36) of severely injured patients.
  
  
  METHODS
  A written questionnaire was sent to 121 trauma patients who received treatment in two hospitals in Cologne/Northrhine-Westfalia between 1996 and 2001. The inclusion criteria were more than one injury and a sum of abbreviated injury score of the two worst injuries ≥ 6. The response rate after using the total-design-method was 77.6% (n = 90).
  
  
  RESULTS
  Severely injured patients showed significant reductions for all subscales of the SF-36, on average 4 years after discharge on average, in comparison to a German norm population. Specifically, aspects of the physical-component scale were dramatically reduced. Linear regressions controlling for time after discharge suggested that higher age, lower socioeconomic status, living together with a partner, and the severity of trauma and injury of extremities were significant predictors for a reduced quality of life, while satisfaction with the hospital stay had a positive effect.
  
  
  CONCLUSIONS
  All in all, it is important to identify trauma- patients who will suffer a reduced quality of life. In so doing, it will be possible to take into account the specific circumstances of their recovery during medical treatment, care, and rehabilitation.
authors.affiliation: Department of Medical Sociology, Medical Faculty, Institute and Polyclinic for Occupational and Social Medicine, University of Cologne, Cologne, Germany. christian.janssen@uk-koeln.de.|Department of Medical Sociology, Medical Faculty, Institute and Polyclinic for Occupational and Social Medicine, University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany. christian.janssen@uk-koeln.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Janssen
authors.affiliation: Medical Faculty, ZVFK - Center for Health Services Research Cologne, University of Cologne, Cologne, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ommen
authors.affiliation: Faculty of Medicine, Institute for Research in Operative Medicine, University of Witten/Herdecke, Witten, Germany.
authors.forename: Edmund
authors.initials: E
authors.lastname: Neugebauer
authors.affiliation: Faculty of Medicine, Institute for Research in Operative Medicine, University of Witten/Herdecke, Witten, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of Medical Sociology, Medical Faculty, Institute and Polyclinic for Occupational and Social Medicine, University of Cologne, Cologne, Germany.|Medical Faculty, ZVFK - Center for Health Services Research Cologne, University of Cologne, Cologne, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
keywords: Health-related quality of life; Patient reported outcome; Severely injured patients