Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Ann Surg ; 276(1): 22-29, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703455

RESUMO

OBJECTIVE: The aim of this study was to evaluate the Social Vulnerability Index (SVI) as a predictor of long-term outcomes after injury. BACKGROUND: The SVI is a measure used in emergency preparedness to identify need for resources in the event of a disaster or hazardous event, ranking each census tract on 15 demographic/social factors. METHODS: Moderate-severely injured adult patients treated at 1 of 3 level-1 trauma centers were prospectively followed 6 to 14 months post-injury. These data were matched at the census tract level with overall SVI percentile rankings. Patients were stratified based on SVI quartiles, with the lowest quartile designated as low SVI, the middle 2 quartiles as average SVI, and the highest quartile as high SVI. Multivariable adjusted regression models were used to assess whether SVI was associated with long-term outcomes after injury. RESULTS: A total of 3153 patients were included [54% male, mean age 61.6 (SD = 21.6)]. The median overall SVI percentile rank was 35th (IQR: 16th-65th). compared to low SVI patients, high SVI patients were more likely to have new functional limitations [odds ratio (OR), 1.51; 95% confidence interval (CI), 1.19-1.92), to not have returned to work (OR, 2.01; 95% CI, 1.40-2.89), and to screen positive for post-traumatic stress disorder (OR, 1.56; 95% CI, 1.12-2.17). Similar results were obtained when comparing average with low SVI patients, with average SVI patients having significantly worse outcomes. CONCLUSIONS: The SVI has potential utility in predicting individuals at higher risk for adverse long-term outcomes after injury. This measure may be a useful needs assessment tool for clinicians and researchers in identifying communities that may benefit most from targeted prevention and intervention efforts.


Assuntos
Vulnerabilidade Social , Transtornos de Estresse Pós-Traumáticos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Centros de Traumatologia
2.
J Trauma Acute Care Surg ; 91(3): 552-558, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34108418

RESUMO

BACKGROUND: The strength of one's social support network is a potentially modifiable factor that may have a significant impact on recovery after injury. We sought to assess the association between one's perceived social support (PSS) and physical and mental health outcomes 6 months to 12 months postinjury. METHODS: Moderate to severely injured patients admitted to one of three Level I trauma centers were asked to complete a phone-based survey assessing physical and mental health outcomes in addition to return to work and chronic pain 6 months to 12 months postinjury. Patients were also asked to rate the strength of their PSS on a 5-point Likert scale. Multivariate linear and logistic regression models were built to determine the association between PSS and postdischarge outcome metrics. RESULTS: Of 907 patients included in this study, 653 (72.0%) identified themselves as having very strong/strong, 182 (20.1%) as average, and 72 (7.9%) as weak/nonexistent PSS. Patients who reported a weak/nonexistent PSS were younger and were more likely to be male, Black, and to have a lower level of education than those who reported a very strong/strong PSS. After adjusting for potential confounders, patients with a weak/nonexistent PSS were more likely to have new functional limitations and chronic pain in addition to being less likely to be back at work/school and being more likely to screen positive for symptoms of posttraumatic stress disorder, depression and anxiety at 6 months to 12 months postinjury than those with a strong/very strong PSS. CONCLUSION: Lower PSS is strongly correlated with worse functional and mental health outcome metrics postdischarge. The strength of one's social support network should be considered when trying to identify patients who are at greatest risk for poor postdischarge outcomes after injury. Our data also lend support to creating a system wherein we strive to build a stronger support network for these high-risk individuals. LEVEL OF EVIDENCE: Prognostic/epidemiologic, level III.


Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Apoio Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Ferimentos e Lesões/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/etiologia , Ansiedade/psicologia , Depressão/epidemiologia , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Escala de Gravidade do Ferimento , Modelos Lineares , Modelos Logísticos , Masculino , Massachusetts , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Qualidade de Vida , Recuperação de Função Fisiológica , Medição de Risco , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Centros de Traumatologia/estatística & dados numéricos , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...