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Bestandsaufnahme der Schmerzsituation von Schwerstverletzten zwei Jahre nach Trauma

Pain assessment of severely injured patients 2 years after trauma

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Zusammenfassung

Hintergrund und Fragestellung

Noch Jahre nach einem Trauma berichten schwerverletzte Patienten regelhaft über fortbestehende Schmerzen. Jedoch gibt es keine Daten zur Situation der ambulanten Schmerzmitteleinnahme und Mitbehandlung durch spezielle Schmerztherapeuten. Ziel der vorliegenden Studie ist es, die gesundheitsbezogene Lebensqualität von Traumapatienten mit bzw. ohne starke Schmerzen, die Schmerzmitteleinnahmerate und die Anzahl der Patienten, die von einem Schmerztherapeuten behandelt werden innerhalb von zwei Jahren nach Trauma zu evaluieren.

Material und Methoden

In der vorliegenden Auswertung wurden Daten von Schwerverletzten, die 2008–2011 in unserer Klinik behandelt wurden, ausgewertet. Das Einschlusskriterium war Volljährigkeit. Ausschlusskriterien waren Tod und kognitive Einschränkungen, die eine selbstständige Beantwortung des Fragebogens ausschlossen. Die Daten umfassen das validierte „Trauma Outcome Profile“ zur Erhebung der Lebensqualität und einen Fragebogen mit gezielten Fragen zur ambulanten Schmerztherapie.

Ergebnisse und Diskussion

Für die Auswertung standen 207/391 (53 %) der Datensätze schwerstverletzter Patienten (ISS 19) zur Verfügung. Davon waren 67 % männlich, das Durchschnittsalter lag bei 44 Jahren. Es wiesen 23 Monate nach Trauma 59 % der Patienten starke Schmerzen auf und damit einhergehend eine deutlich reduzierte Lebensqualität. Nur die Hälfte der Patienten mit starken Schmerzen nahmen zwei Jahre nach Trauma Analgetika ein. Nur jeder Fünfte wurde durch einen speziellen Schmerztherapeuten mitbehandelt. Da in der Literatur erfolgreiche Therapieoptionen zur Vermeidung chronischer postoperativer/-traumatischer Schmerzen beschrieben wird, ist eine Verbesserung der schmerztherapeutischen Behandlung auf ambulanter Ebene zu fordern.

Abstract

Background and objectives

Trauma patients often suffer from persisting pain even years after injury, and data on long-term pain management is lacking. The aim of this study was to evaluate the frequency of persisting pain and health-related quality of life (HrQoL) among trauma victims 2 years after injury. Furthermore, the frequency of pain specialist consultation and the quality of outpatient pain management, including phamacological management, was assessed.

Materials and methods

We analyzed prospectively collected data on severely injured adult patients treated between 2008–2011 at the Cologne Merheim Medical Center (CMMC)/Germany.  Data included the ‘Polytrauma Outcome Profile’ and a standardized questionnaire on outpatient pain management. Exclusion criteria were death, inability to answer the questionnaire due to cognitive disabilities and lack of language knowledge.

Results and conclusions

207/391 (53 %) data sets were available for analysis, presenting a typical trauma collective with injury severity of ISS 19, predominantly male and a mean age of 44 years. 2 years after trauma 59 % still reported that they suffered from severe persisting pain; 53 % of these patients were under pharmacological pain medication. Only 1/5 of the patients with severe persisting pain was treated by a pain specialist. Successful treatment options do exist; improvement of treatment is required.

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Authors and Affiliations

  1. Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Krankenhaus Köln-Merheim, Universität Witten/Herdecke, Ostmerheimerstr.200, 51109, Köln, Deutschland

    S. Kaske, B. Bouillon, M. Maegele, A. Driessen, C. Probst & C. Simanski

  2. Institut für Forschung in der Operativen Medizin (IFOM), Universität Witten/Herdecke, Köln, Deutschland

    S. Kaske, R. Lefering & M. Maegele

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  1. S. Kaske
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  2. R. Lefering
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  3. B. Bouillon
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  4. M. Maegele
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  5. A. Driessen
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  6. C. Probst
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  7. C. Simanski
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Correspondence to S. Kaske.

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Interessenkonflikt

S. R. Kaske, R. Lefering, B. Bouillon, M. Maegele, A. Driessen, C. Probst und C. Simanski geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Kaske, S., Lefering, R., Bouillon, B. et al. Bestandsaufnahme der Schmerzsituation von Schwerstverletzten zwei Jahre nach Trauma. Schmerz 30, 273–278 (2016). https://doi.org/10.1007/s00482-016-0112-y

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  • DOI: https://doi.org/10.1007/s00482-016-0112-y

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