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Trajectories of quality of life in patients with traumatic limb injury: a 2-year follow-up study

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Abstract

Purpose

Traumatic limb injury (TLI) can have a negative impact on a patient’s quality of life (QOL), and the patient’s QOL may fluctuate over time. However, the longitudinal change patterns of QOL in patients with TLI are largely unknown. The aim of this study was to investigate the QOL trajectories in patients with TLI in 4 QOL domains: physical capacity, psychological well-being, social relationships, and environment.

Methods

The patients’ QOL was assessed within 14 days and at 1, 3, 6, 12, and 24 months after injury. In each QOL domain, 4 latent growth curve models (LGMs, including non-growth, linear growth, quadratic growth, and cubic LGM) were adopted to examine the QOL trajectories across the 6 time points.

Results

A total of 499 patients completed the 6 assessments. For all 4 QOL domains, the cubic LGM had the best model fitting (root-mean-square error of approximation < 0.01) revealing that the patients’ 4 QOL domains changed with cubic trajectories: QOL improved in the first 6 months, deteriorated in the second 6 months, and improved smoothly at 12–24 months after injury.

Conclusions

This study found that the trajectories in the 4 QOL domains were cubic trajectories in patients with TLI. These findings indicate that clinicians should pay additional attention to improve the patients’ QOL in the first 6 months after injury and to prevent or reduce QOL deterioration at 6–12 months.

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References

  1. Holtslag, H., Buskens, E., Rommers, C., Prevo, A., & van der Werken, C. (2006). Long-term outcome after lower extremity injuries in severely injured patients. European Journal of Trauma and Emergency Surgery, 32(4), 365–373.

    Article  Google Scholar 

  2. Marinković, M., Janjić, Z., & Nikolić, J. (2015). Estimating disability and quality of life after different degrees of hand and forearm trauma. Vojnosanitetski Pregled., 72(2), 155–159.

    Article  PubMed  Google Scholar 

  3. Bailey, R., Kaskutas, V., Fox, I., Baum, C. M., & Mackinnon, S. E. (2009). Effect of upper extremity nerve damage on activity participation, pain, depression, and quality of life. Journal of Hand Surgery, 34(9), 1682–1688.

    Article  PubMed  Google Scholar 

  4. Bryant, R. A., O’Donnell, M. L., Creamer, M., McFarlane, A. C., Clark, C. R., & Silove, D. (2010). The psychiatric sequelae of traumatic injury. American Journal of Psychiatry, 167(3), 312–320.

    Article  PubMed  Google Scholar 

  5. WHOQOL group. (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine, 41(10), 1403–1409.

    Article  Google Scholar 

  6. Johnson, J. R., & Temple, R. (1985). Food and drug administration requirements for approval of new anticancer drugs. Cancer Treatment Reports, 69(10), 1155–1159.

    CAS  PubMed  Google Scholar 

  7. Grady, K. L., Meyer, P. M., Dressler, D., Mattea, A., Chillcott, S., Loo, A., et al. (2004). Longitudinal change in quality of life and impact on survival after left ventricular assist device implantation. The Annals of Thoracic Surgery, 77(4), 1321–1327.

    Article  PubMed  Google Scholar 

  8. Steer, J., Gibson, G. J., & Bourke, S. C. (2015). Longitudinal change in quality of life following hospitalisation for acute exacerbations of COPD. BMJ Open Respiratory Research, 2(1), e000069.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Schwartz, C. E., & Sprangers, M. A. G. (1999). Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Social Science and Medicine, 48(11), 1531–1548.

    Article  CAS  PubMed  Google Scholar 

  10. Bush, N. E., Donaldson, G. W., Haberman, M. H., Dacanay, R., & Sullivan, K. M. (2000). Conditional and unconditional estimation of multidimensional quality of life after hematopoietic stem cell transplantation: A longitudinal follow-up of 415 patients. Biology of Blood and Marrow Transplantation, 6(5), 576–591.

    Article  CAS  PubMed  Google Scholar 

  11. Herndon, J. E., Fleishman, S., Kosty, M. P., & Green, M. R. (1997). A longitudinal study of quality of life in advanced non-small cell lung cancer: Cancer and Leukemia Group B (CALGB) 8931. Controlled Clinical Trials, 18(4), 286–300.

    Article  CAS  PubMed  Google Scholar 

  12. Zidarov, D., Swaine, B., & Gauthier-Gagnon, C. (2009). Quality of life of persons with lower-limb amputation during rehabilitation and at 3-month follow-up. Archives of Physical Medicine and Rehabilitation, 90(4), 634–645.

    Article  PubMed  Google Scholar 

  13. Stensman, R. (1994). Adjustment to traumatic spinal cord injury. A longitudinal study of self-reported quality of life. Paraplegia, 32(6), 416–422.

    Article  CAS  PubMed  Google Scholar 

  14. Hou, W.-H., Sheu, C.-F., Liang, H.-W., Hsieh, C.-L., Lee, Y., Chuang, H.-Y., et al. (2012). Trajectories and predictors of return to work after traumatic limb injury—A 2-year follow-up study. Scandinavian Journal of Work, Environment & Health, 38(5), 456–466.

    Article  Google Scholar 

  15. Hou, W.-H., Liang, H.-W., Sheu, C.-F., Hsieh, C.-L., & Chuang, H.-Y. (2013). Return to work and quality of life in workers with traumatic limb injuries: A 2-year repeated-measurements study. Archives of Physical Medicine and Rehabilitation, 94(4), 703–710.

    Article  PubMed  Google Scholar 

  16. Hou, W.-H., Liang, H.-W., Hsieh, C.-L., Sheu, C.-F., Hwang, J.-S., & Chuang, H.-Y. (2013). Integrating health-related quality of life with sickness leave days for return-to-work assessment in traumatic limb injuries. Quality of Life Research, 22(9), 2307–2314.

    Article  PubMed  Google Scholar 

  17. Leung, K. F., Wong, W. W., Tay, M. S., Chu, M. M., & Ng, S. S. (2005). Development and validation of the interview version of the Hong Kong Chinese WHOQOL-BREF. Quality of Life Research, 14(5), 1413–1419.

    Article  CAS  PubMed  Google Scholar 

  18. Yao, G., Chung, C.-W., Yu, C.-F., & Wang, J.-D. (2002). Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. Journal of the Formosan Medical Association, 101(5), 342–351.

    PubMed  Google Scholar 

  19. Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299–310.

    Article  CAS  PubMed  Google Scholar 

  20. Bonnetain, F., Bouche, O., Michel, P., Mariette, C., Conroy, T., Pezet, D., et al. (2006). A comparative longitudinal quality of life study using the Spitzer quality of life index in a randomized multicenter phase III trial (FFCD 9102): Chemoradiation followed by surgery compared with chemoradiation alone in locally advanced squamous resectable thoracic esophageal cancer. Annals of Oncology, 17(5), 827–834.

    Article  CAS  PubMed  Google Scholar 

  21. Lix, L. M., Graff, L. A., Walker, J. R., Clara, I., Rawsthorne, P., Rogala, L., et al. (2008). Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease. Inflammatory Bowel Diseases, 14(11), 1575–1584.

    Article  PubMed  Google Scholar 

  22. Bentler, P. M. (1995). EQS structural equations program manual. Encino, CA: Multivariate Software.

    Google Scholar 

  23. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.

    Article  Google Scholar 

  24. Hardt, J., Herke, M., & Leonhart, R. (2012). Auxiliary variables in multiple imputation in regression with missing X: A warning against including too many in small sample research. BMC Medical Research Methodology, 12(1), 1–13.

    Article  Google Scholar 

  25. Holbrook, T. L., Anderson, J. P., Sieber, W. J., Browner, D., & Hoyt, D. B. (1998). Outcome after major trauma: Discharge and 6-month follow-up results from the Trauma Recovery Project. Journal of Trauma and Acute Care Surgery, 45(2), 315–324.

    Article  CAS  Google Scholar 

  26. Carod-Artal, J., Egido, J. A., González, J. L., & De Seijas, E. V. (2000). Quality of life among stroke survivors evaluated 1 year after stroke: Experience of a stroke unit. Stroke, 31(12), 2995–3000.

    Article  CAS  PubMed  Google Scholar 

  27. Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine, 48(11), 1507–1515.

    Article  CAS  PubMed  Google Scholar 

  28. Anderson, P. A., Carreon, L. Y., & Glassman, S. D. (2009). Response shift phenomenon. Does this apply to spine outcomes research? The Spine Journal, 9(12), 1037–1038.

    Article  PubMed  Google Scholar 

  29. World Health Organization. (2001). International classification of functioning, disability and health: ICF. Geneva: World Health Organization.

    Google Scholar 

  30. Boik, R. J. (1988). The mixed model for multivariate repeated measures: Validity conditions and an approximate test. Psychometrika, 53(4), 469–486.

    Article  Google Scholar 

  31. Levasseur, M., Desrosiers, J., & Whiteneck, G. (2010). Accomplishment level and satisfaction with social participation of older adults: Association with quality of life and best correlates. Quality of Life Research, 19(5), 665–675.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Levasseur, M., Desrosiers, J., & Noreau, L. (2004). Is social participation associated with quality of life of older adults with physical disabilities? Disability and Rehabilitation, 26(20), 1206–1213.

    Article  PubMed  Google Scholar 

  33. Gibbons, R. D., Hedeker, D., & DuToit, S. (2010). Advances in analysis of longitudinal data. Annual Review of Clinical Psychology, 6, 79.

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The study was carried out with the financial support from the National Science Council (NSC-101-2314-B-038-055).

Author information

Author notes

    Authors and Affiliations

    1. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

      Gong-Hong Lin, Yi-Jing Huang, Chien-Yu Huang & Ching-Lin Hsieh

    2. School of Occupational Therapy, Chung Shan Medical University, and Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan

      Wen-Shian Lu

    3. Department of Physical Medicine and Rehabilitation, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan

      Sheng-Shiung Chen

    4. Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City, 110, Taiwan

      Wen-Hsuan Hou

    5. School of Gerontology and Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan

      Wen-Hsuan Hou

    6. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan

      Wen-Hsuan Hou

    7. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan

      Ching-Lin Hsieh

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    1. Gong-Hong Lin
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    Corresponding author

    Correspondence to Wen-Hsuan Hou.

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    Conflict of interest

    The authors Gong-Hong Lin, Yi-Jing Huang, Chien-Yu Huang, Wen-Shian Lu, Sheng-Shiung Chen, Wen-Hsuan Hou, and Ching-Lin Hsieh declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Wen-Hsuan Hou and Ching-Lin Hsieh have contributed equally to this work.

    Appendix

    Appendix

    See Table 4.

    Table 4 Demographic and baseline characteristics of the subgroups
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    Cite this article

    Lin, GH., Huang, YJ., Huang, CY. et al. Trajectories of quality of life in patients with traumatic limb injury: a 2-year follow-up study. Qual Life Res 25, 2283–2293 (2016). https://doi.org/10.1007/s11136-016-1274-x

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    • DOI: https://doi.org/10.1007/s11136-016-1274-x

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