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Prof. Dr. Florian Michael Baumann

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Guest Editor

Department of Trauma Surgery, Regensburg University Medical Center, 93042 Regensburg, Germany
Interests: pelvic fracture management; acetabulum fractures; hip surgery; pediatric trauma
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Prof. Dr. Viola Freigang

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Faculty of Interdisciplinary Studies, University of Applied Sciences Landshut, Am Lurzenhof 1, 84036 Landshut, Germany
Interests: major trauma; patient-reported outcome; registry-based studies

Special Issue Information

Dear Colleagues,

Trauma and musculoskeletal disorders are a major burden leading to immobilization and a reduction in the health-related quality of life (HRQoL). Advances in the diagnostics and treatment of musculoskeletal disorders have led to remarkable progress in the standard of care over the past decade. For the evaluation of medical interventions, patients' perspectives are gaining more and more significance, and "Patient-Reported Outcome Measurement" (PROM) has become a standard instrument for outcome evaluation and health technology assessment.

Registry-based research, innovations in the digital planning of surgery, and navigation applications have initiated a digital revolution in healthcare. Interdisciplinary and inter-professional collaboration may improve the value of clinical pathways and lead to better outcomes. The aim of this Special Issue is to provide a comprehensive platform for innovations in trauma and orthopaedic surgery and their impact on patient-reported outcomes and healthcare implications.

We invite manuscripts from all scientific fields of musculoskeletal research to contribute to our mission of improving healthcare outcomes in trauma and orthopaedic surgery.

Sincerely,

Prof. Dr. Florian Michael Baumann
Prof. Dr. Viola Freigang
Guest Editors

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13 pages, 1052 KiB

Open AccessArticle

Sex-Specific Factors Affecting Quality of Life After Major Trauma: Results of a Prospective Multicenter Registry-Based Cohort Study

by Viola Freigang, Karolina Müller, Antonio Ernstberger, Volker Alt, Anne Herrmann-Johns and Florian Baumann

Healthcare 2025, 13(4), 437; https://doi.org/10.3390/healthcare13040437 - 18 Feb 2025

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Abstract

Background: Major trauma is a leading cause of severe disability and mortality. The influence of patient sex on outcome after severe trauma is a topic of ongoing discussion. We present a prospective multicenter study on the effects of trauma severity on health-related quality of life (HRQoL) of female patients. We hypothesized that the impairment of HRQoL after major trauma between the sexes depends not only on sex itself but also on age. Methods: This multicenter prospective registry-based observational study compared sex-based differences in HRQoL of patients who sustained major trauma Injury Severity Score (ISS ≥ 16). The HRQoL was assessed using the EQ-5D-3L (European Quality of Life 5-Dimension 3-Level Version) score over 2 years post-trauma. Results: We included 416 patients (116 female/300 male) with an ISS > 16 (median ISS 22 IQR 18/30). All patients had a lower HRQoL after trauma than the population norm. Increased AIS (Abbreviated Injury Scale) face and extremity scores and ASA (American Society of Anesthesiologists) scores showed a significant decrease in HRQoL. Even though the groups of female and male patients were comparable in injury severity, female patients reported significantly more problems on the anxiety and depression scales than male patients 6 months (p = 0.003) and 24 months (p = 0.044) after trauma (6 months: female 46% vs. male 30%; 24 months: female 44% vs. male 32%). We observed the greatest improvement in the EQ Index over time in patients between 16 and 39 years of age, especially female patients (0.78 to 0.87 in females under 39 years of age, compared to males in the same age group 0.76 to 0.81). Females over 65 years of age initially presented the lowest EQ Index of 0.62. It remained significantly lower over time and was lower compared to male patients of the same age group (female EQ Index after 24 months was 0.68 compared to men over the age of 65 who presented an EQ Index of 0.75). Conclusions: All patients included in this study presented a lower HRQoL after trauma than the population norm. Female patients under 39 years of age reported the most improvement. Females over 65 years of age showed a limited HRQoL, which remained significantly lower over time. Female patients reported significantly more anxiety and depression after major trauma than male patients. Thus, further development and methodologically rigorous testing of ortho-geriatric initiatives, psychosocial support, and prevention measures are required to improve the care after major trauma, particularly for the female elderly. Full article

(This article belongs to the Special Issue Healthcare Advances in Trauma and Orthopaedic Surgery)

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