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Shahan CP, Nishtala M, Matabele MM, Zarzaur BL. Patient-Reported Outcomes and PTSD Symptoms in Emergency General Surgery. J Surg Res 2024; 302:317-323. [PMID: 39121799 DOI: 10.1016/j.jss.2024.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/26/2024] [Accepted: 07/07/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION Patient-reported outcomes (PRO) are increasingly recognized as a measure of surgical quality and long-term outcomes. There are few PRO data for patients undergoing emergency general surgery (EGS) procedures. Sudden illness and injury are associated with worse health-related quality of life, symptoms of depression, post-traumatic stress. This study aimed to evaluate PRO and post-traumatic stress disorder (PTSD) symptoms in an EGS population. METHODS Patients who underwent an EGS operation and had quality improvement data available from Jan 2020 to Jan 2021 were eligible for inclusion. Participants completed a survey of demographics, socio-economic status, PROMIS PRO measures for general life satisfaction (GLS), general self-efficacy (GSE), and physical function (PF), and the PCL-5 PTSD symptom screening tool. RESULTS One hundred forty-one patients were eligible for inclusion, 40 (28%) completed the study. Mean PRO scores were 52.5 ± 9.3 for GLS, 48.6 ± 8.0 for GSE, and 48.7 ± 9.6 for PF. 12.5% of patients had a low or very low GLS and GSE score, while 32.5% had mild, moderate, or severe PF scores. Seven patients (17.5%) scored >31 on PCL-5 indicating a positive PTSD screen. Regression analysis found American society of anesthesiology score, emergency case, and lower income associated with lower GLS scores. Age, body mass index, and lower income were associated with lower PF scores. CONCLUSIONS We found that following EGS most patients have average PRO. This limited study did also identify that there are patients potentially at risk for worse functional and mental health outcomes. We plan to use this data to prospectively evaluate the role that EGS plays in these outcomes and how they can be improved on.
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Affiliation(s)
| | - Madhuri Nishtala
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Ben L Zarzaur
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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McGeough G, Davidson C, Aslam-Pervez B, Laraway D. Patient reported outcome measures (PROMs) in zygomatic fracture surgery. Br J Oral Maxillofac Surg 2024; 62:378-382. [PMID: 38599931 DOI: 10.1016/j.bjoms.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 04/12/2024]
Abstract
Attitudes towards healthcare in the NHS and in other Western healthcare systems have been changing dramatically in recent years. There is a significant movement calling for a shift from the traditional paternalistic model, with patients as passive recipients of treatments that are supported by objective and observable evidence, towards a more holistic approach, in which patients have agency, and treatments are tailored to the individual needs of a particular patient. Whilst patient safety and clinical effectiveness remain intrinsic to the traditional measurement of successful healthcare, Patient Reported Outcome Measures (PROMs) are increasingly being advocated as an important tool to uphold patient-centric care in the NHS.The aim of this study is to complete the first evaluation of PROMs that we know of in patients receiving surgical management of zygomatic fractures, by comparing two interventions commonly used in this condition: the zygomaticomaxillary complex open reduction and internal fixation (ZMC ORIF), and the Gillies approach to zygomatic elevation. We demonstrate high levels of patient satisfaction across all domains, irrespective of surgical approach, but that mood and anxiety remain an issue after surgery.
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Anwar Z, McLeod NMH, Van den Bosch P, Cairns M. A review of the use of patient reported outcome measures (PROMS) in temporomandibular joint (TMJ) surgery. J Craniomaxillofac Surg 2024; 52:181-187. [PMID: 38143160 DOI: 10.1016/j.jcms.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/09/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Temporomandibular joint (TMJ) surgery accounts for a significant number of patient episodes in oral and maxillofacial surgery, and treatment effectiveness is commonly assessed using measures of pain and mouth opening. Patient-reported outcome measures (PROMs) enable assessment of the patient's perspective and perception of the diseases and treatment outcomes. The purpose of this review was to assess the use of PROMs in TMJ surgery. A review of 3 databases (PubMed, OVID, Trip) was carried out to assess the use of PROMs when reporting on TMJ surgical interventions. Studies were limited to the English language, involving humans and at least one surgical intervention of the TMJ. A total of 214 articles met the inclusion and exclusion criteria, of which only 28 used 18 PROMs among them. Half of these PROMs were single-question visual analogue scales or Likert scales on quality of life and disability. The Oral Health Impact Profile and the Helkimo Clinical Dysfunction Index were the second most used (n = 3). PROMs were used most in studies on internal derangement (n = 9) and in cohort study designs (n = 26), but this was not statistically significant. In the majority of research on TMJ surgery, no PROMs are used, and when one is, there is a tendency to use weaker single-question PROMs as opposed to multi-question PROMs to assess outcomes. With the increasing importance of PROMs for assessing patients' perception of treatment outcomes, further research is needed to establish valid and reproducible PROMs for TMJ surgery.
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Affiliation(s)
- Zuhair Anwar
- Department of Oral and Maxillofacial Surgery, Barts Health NHS trust, UK.
| | - Niall M H McLeod
- Department of Oral & Maxillofacial Surgery, University Hospitals Coventry and Warwickshire, UK; Department of Oral and Maxillofacial Surgery, Barts Health NHS trust, UK.
| | - Peter Van den Bosch
- Department of Oral and Maxillofacial Surgery, Manchester Foundation Trust, UK.
| | - Mark Cairns
- Department of Oral and Maxillofacial Surgery, Barts Health NHS trust, UK.
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Lubamba GP, Dai X, Song Z, Al-Shujaa EA, Guan J, Wang X, Isouradi-Bourley JPS, Zhang Y, Milolo AM, Bushabu FN, Xu P, Che D. Assessment of quality of life in patients treated for orbital fractures. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101486. [PMID: 37105493 DOI: 10.1016/j.jormas.2023.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE This study aimed to assess the quality of life (QOL), before and after surgery, of patients who underwent open reduction and internal fixation for orbital fractures. STUDY DESIGN A prospective study. PARTICIPANTS AND SETTING The self-report outcome measures of 50 patients treated at the Department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital of Jiamusi University from January 2016 to June 2019 were prospectively collected. MAIN MEASURES The quality of life was assessed using four patient-reported outcome measures (PROMs): the 15D questionnaire, Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS), and 36-item Short Form Survey (SF-36). Both descriptive and comparative data analyses were calculated. RESULTS Zygomaticomaxillary complex fractures were the most encountered (40.3%). The total OHIP-14 scores before and after treatment were 1.72 and 1.68, respectively. Vision, breathing, sleeping, eating, usual activities, discomfort and symptoms, and vitality showed minimal changes in the 15D questionnaire. The HADS scores were ranged from 0 to 7, indicating no anxiety or depression. The comparison of SF-36 scores after 3 months and after ≥6 months of treatment revealed no significant difference. CONCLUSIONS Patients' QOL was minimally impacted by orbital fractures and their treatments. The severity of the negative impact can be minimized if appropriate management strategies are taken.
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Affiliation(s)
- Grace Paka Lubamba
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo; Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinpeng Dai
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Zhenyu Song
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Eissa A Al-Shujaa
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Guan
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China.
| | - Xinyu Wang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | | | - Yanqi Zhang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Augustin Mantshumba Milolo
- Department of Prosthodontics, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Fidele Nyimi Bushabu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Pengkun Xu
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Di Che
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
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Helmer LM, Dubois L, Lobbezoo F, de Lange J, Bosmans JE. Healthcare costs of different treatment options for condylar fractures. Heliyon 2023; 9:e19851. [PMID: 37809381 PMCID: PMC10559232 DOI: 10.1016/j.heliyon.2023.e19851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Objective As treatment options for condylar fractures have comparable outcomes, getting insight into associated costs is a first step towards implementing value-based healthcare (VBH). Therefore, we described the actual costs of the different treatment options (surgical, conservative, and expectative treatment) for condylar fractures. We expected surgical treatment to be the most expensive treatment. Study design This is a cost-of-illness study, based on estimates from the literature. Firstly, care pathways of all treatment options were described. Secondly, the costs per step were calculated based on the literature and Dutch guidelines for economic evaluations in health care. Results The direct treatment costs of surgical treatment (€3721 to €4040) are three to five times higher than conservative treatment (€730 to €1332). When lost productivity costs during the recovery period are included, costs of surgical treatment remain 1.5 times higher (€9511 to €9830 for surgical treatment and €6224 to €6826 for conservative treatment). The costs of expectative treatment (€5436) are lower than both other treatments. Conclusion The costs for surgical treatment are considerably higher than those for conservative or expectative treatment, mainly related to direct treatment cost. Future research should focus on the patients' perspective, to support implementation of VBH in treating condylar fractures.
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Affiliation(s)
- Loreine M.L. Helmer
- Department of Oral and Maxillofacial Surgery, Academic Medical Centre of Amsterdam (AUMC) and Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Meibergdreef 9, AZ Amsterdam ZO, Amsterdam, 1105, the Netherlands
| | - Leander Dubois
- Department of Oral and Maxillofacial Surgery, Academic Medical Centre of Amsterdam (AUMC), Academic Centre for Dentistry (ACTA), University of Amsterdam, Amsterdam, Meibergdreef 9, AZ Amsterdam ZO, 1105, the Netherlands
| | - Frank Lobbezoo
- Departments of Oral Health Sciences and of Orofacial Pain and Dysfunction, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Centre of Amsterdam (AUMC), Academic Centre for Dentistry (ACTA), University of Amsterdam, Meibergdreef 9, AZ Amsterdam ZO, Amsterdam, 1105, the Netherlands
| | - Judith E. Bosmans
- Section Health Technology Assessment, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT Amsterdam, the Netherlands
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Só BB, Jardim LC, Schuch LF, Kovalski LNS, Zan R, Calcagnotto T, Martins MD, Martins MAT. Analysis of factors that influence quality of life of individuals undergoing treatment for mandibular fractures: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:289-301. [PMID: 35440426 DOI: 10.1016/j.oooo.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/22/2021] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To address the factors that affect the quality of life (QoL) of individuals undergoing treatment for mandibular fractures. STUDY DESIGN This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the search strategy was constructed according to the Populations, Interventions, Comparison, Outcomes, and Study Design principle in the following databases: PubMed, Web of Science, Scopus, and EMBASE. Risk of bias assessment was performed with Risk Of Bias In Non-randomized Studies of Interventions and Cochrane Risk of Bias tool for randomized trials 2. RESULTS Nineteen studies were included: 15 observational and 4 clinical trials. Mean age ranged from 28 to 39 years, with a higher proportion of males. The condyle was the main fracture location and traffic accident was the fracture cause. Treatment approaches were mostly open reduction (89.4%) and maxillomandibular fixation (63%). QoL measurements varied considerably with the General Oral Health Assessment Index (31.5%) and Oral Health Impact Profile-14 (21%) as the main instruments. Meta-analysis showed that open reduction and maxillomandibular fixation did not present significant differences to QoL (P = .39), but significant differences were observed with time (P < .00001). Other factors affected QoL, such as mental health, pain, socializing, appearance, and eating difficulties. CONCLUSIONS Several factors, apart from the treatment approach, mentioned in this review seemed to affect the QoL of patients with mandibular trauma. Treatment choice should be based on well-stablished clinical criteria and on all other factors mentioned here.
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Affiliation(s)
- Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luisa Comerlato Jardim
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Luan Nathiel Santana Kovalski
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafael Zan
- Oral and Maxillofacial Surgery Department, FATEC Dental CEEO, Igrejinha, RS, Brazil
| | - Thiago Calcagnotto
- Oral and Maxillofacial Surgery Department, FATEC Dental CEEO, Igrejinha, RS, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
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Pauli N, Grinups M, Folkestad L, Gudnadottir G. Patient-Reported Symptoms after Midfacial Trauma. Surg J (N Y) 2022; 8:e22-e27. [PMID: 35059499 PMCID: PMC8763470 DOI: 10.1055/s-0041-1742174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background
The aim of this study was to assess patient-reported symptoms and health-related quality of life, 12 to 24 months after injury in patients with midfacial fractures.
Methods
Patients diagnosed with midfacial fractures were assessed regarding symptoms related to the fracture as well as assessment of the patients overall health-related quality of life using the Gothenburg Trismus Questionnaire (GTQ), the Folkestad facial trauma questionnaire, and EuroQol five-dimensional (EQ-5D). Questionnaires were distributed to the study patients 12 to 24 months after the trauma. Medical records were retrospectively surveyed for age, gender, trauma etiology, date of injury, fracture classification, treatment regimen, and time of surgery.
Results
Sixty-seven percent of the study group reports sensibility disturbance in the face 12 to 24 months after trauma and 52% reported cosmetic consequences related to the trauma. Numbness in the face was the symptom reported to be most disturbing for the patients. Few of the patients reported severe jaw-related problems, problems with muscular tension, or eating limitation according to the validated questionnaire GTQ.
Conclusion
Sensibility disturbance remains a significant and common symptom 12 to 24 months after midfacial trauma. There is a need for a validated patient-reported outcome instrument for facial trauma that covers multiple aspects of facial trauma such as vision disturbance and diplopia, jaw-related problems, and facial pain as well as sensibility disturbance and cosmetic consequences.
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Affiliation(s)
- Nina Pauli
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martina Grinups
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena Folkestad
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnhildur Gudnadottir
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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McLeod NM, Keenan M. Towards a consensus for classification of mandibular condyle fractures. J Craniomaxillofac Surg 2021; 49:251-255. [PMID: 33589333 DOI: 10.1016/j.jcms.2021.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/09/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022] Open
Abstract
The merits of surgical treatment of fractures of the mandibular condyle versus non-surgical management remains highly controversial, despite a large volume of literature dedicated to this topic. One reason the controversy remains, is because most of the outcomes in the literature are not directly comparable. The disparate range of condylar fracture classifications used is one of the reasons that studies are not comparable. We sought to review classification systems for condylar fractures used in the recent scientific literature. Review of the literature from 2016 to 2019, looking for papers relating to fractures of the mandibular condyle. Papers identified were assessed for type of study, focus of study, classification system used. 88 studies were identified, including prospective and retrospective cohort studies, randomised and non-randomised prospective studies, randomised controlled trials and case series. More studies focussed on epidemiological factors than surgical access, fixation or outcomes. 31 used no classification system, whilst 17 used unique classification systems and 40 used previously referenced classification systems. Classification systems are used to help separate clinical problems into distinguishable groups, where there is a difference in management or outcome depending on the distinguishing features. There is currently a wide diversity of classification systems used for condyle fractures, and as a result, comparisons of surgical access, fixation and outcomes are difficult to make. Having a single classification system across the published literature would allow easier comparison and the classification proposed by the AO group is recommended for future use.
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Affiliation(s)
- Niall Mh McLeod
- Consultant Oral & Maxillofacial Surgeon, Royal London Hospital, London, UK.
| | - Matthew Keenan
- Simulation Fellow Oral and Maxillofacial Surgery, Royal London Hospital, London, UK
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Singh A, Dhungel S, Kayastha P, Roychoudhury A, Jose A. Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Petersen LØ, Ipsen EØ, Felding UA, von Buchwald C, Steinmetz J. Sequelae of Major Trauma Patients with Maxillofacial Fractures. Ann Otol Rhinol Laryngol 2020; 130:475-482. [PMID: 32935553 DOI: 10.1177/0003489420958732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Sequelae after maxillofacial fractures are frequent and may affect the patient's quality of life. This study examined sequelae associated with maxillofacial fractures of severely traumatized patients focusing mainly on nerve injuries. METHODS A retrospective study including trauma patients with relevant facial fractures admitted to our Trauma Center in the period 2011-2016. Presence of posttraumatic maxillofacial sequelae was identified by examining the medical records of the included patients. Focusing on facial sensory deficits and facial nerve paralysis, but also comprising data on diplopia, blindness, malocclusion, trismus, eye globe malposition, flattening of the malar, facial contour changes, and wound infections. RESULTS Two-hundred-seventy-five severely traumatized patients were included, comprising 201 men (73%), with a median age of 40 years and ISS of 20. 163 (59%) patients only had assessments within 3 months from trauma of which 79 patients (48.5%) had facial complications at initial examination, mostly malocclusion and trismus. Most patients in this group had no or only minor sequelae at their last clinical assessment, mainly being sensory deficits. 112 (41%) patients had assessments both within and beyond 3 months of which 73 patients (65.2%) had facial complications at initial examination, while 91 patients (81%) had reported sequelae within 3 months decreasing to 47 patients (42%) at their last clinical assessment beyond 3 months from trauma, mostly sensory deficits. An improvement of most sequelae was observed. CONCLUSION Objective sequelae were found to be quite common after maxillofacial fractures in severely traumatized patients, especially sensory deficits. However, most of the addressed sequelae seemed to improve over time.
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Affiliation(s)
- Lasse Østrup Petersen
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Emil Ørskov Ipsen
- Trauma Centre and Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Ascanius Felding
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Steinmetz
- Trauma Centre and Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Lupi-Ferandin S, Glumac S, Poljak N, Galic T, Ivkovic N, Brborovic O, Pecotic R, Dogas Z. Health-Related Quality of Life in Patients After Surgically Treated Midface Fracture: A Comparison with the Croatian Population Norm. Ther Clin Risk Manag 2020; 16:261-267. [PMID: 32308403 PMCID: PMC7153997 DOI: 10.2147/tcrm.s249116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/18/2020] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate the health-related life quality of patients after surgically treated midface fractures. Patients and Methods This retrospective cohort study compared the 36-Item Short Form Health Survey (SF-36) scores of 42 male patients following surgically treated maxillary or zygomatic fractures with the reported normative data of the SF-36 for the Croatian population. Results The current study showed that the health-related life quality of surgically treated patients was comparable to similar age, gender, and regional demographics in the Croatian population norm. However, we revealed a significant deterioration of the “Emotional wellbeing” domain in younger patients (P = 0.03) and a severely affected domain of “Physical functioning” in older patients (P = 0.049). Conclusion There was a significant negative psychological impact from facial trauma on younger patients. In contrast, older patients were more prone to physical impairment. Therefore, follow-up visits are an opportunity to screen and refer younger patients to mental health services in a timely manner to prevent severe psychological difficulties and an opportunity to identify older patients who require physical therapy.
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Affiliation(s)
- Slaven Lupi-Ferandin
- Department of Maxillofacial and Oral Surgery, University Hospital of Split, Split, Croatia
| | - Sandro Glumac
- Department of Anesthesiology and Intensive Care, University Hospital of Split, Split, Croatia
| | - Nancy Poljak
- Study of Dental Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tea Galic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia.,Department of Neuroscience, School of Medicine, University of Split, Split, Croatia
| | - Natalija Ivkovic
- Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia
| | - Ognjen Brborovic
- Department of Social Medicine and Organization of Health Care, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Renata Pecotic
- Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.,Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia
| | - Zoran Dogas
- Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.,Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia
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Amnael Orozco-Díaz C, Moorehead R, Reilly GC, Gilchrist F, Miller C. Characterization of a composite polylactic acid-hydroxyapatite 3D-printing filament for bone-regeneration. Biomed Phys Eng Express 2020; 6:025007. [PMID: 33438633 DOI: 10.1088/2057-1976/ab73f8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Autologous cancellous-bone grafts are the current gold standard for therapeutic interventions in which bone-regeneration is desired. The main limitations of these implants are the need for a secondary surgical site, creating a wound on the patient, the limited availability of harvest-safe bone, and the lack of structural integrity of the grafts. Synthetic, resorbable, bone-regeneration materials could pose a viable treatment alternative, that could be implemented through 3D-printing. We present here the development of a polylactic acid-hydroxyapatite (PLA-HAp) composite that can be processed through a commercial-grade 3D-printer. We have shown that this material could be a viable option for the development of therapeutic implants for bone regeneration. Biocompatibility in vitro was demonstrated through cell viability studies using the osteoblastic MG63 cell-line, and we have also provided evidence that the presence of HAp in the polymer matrix enhances cell attachment and osteogenicity of the material. We have also provided guidelines for the optimal PLA-HAp ratio for this application, as well as further characterisation of the mechanical and thermal properties of the composite. This study encompasses the base for further research on the possibilities and safety of 3D-printable, polymer-based, resorbable composites for bone regeneration.
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Affiliation(s)
- C Amnael Orozco-Díaz
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
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13
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An introduction to patient-reported outcome measures (PROMs) in trauma. J Trauma Acute Care Surg 2019; 86:314-320. [DOI: 10.1097/ta.0000000000002102] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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