EducationCorrelation of SF-12 and SF-36 in a Trauma Population1
Introduction
Traumatic injury is measured by the degree of physical and psychological impairment. Recovery can be assessed by return to normal functioning and estimation of the level of quality of life (QoL). Currently there are many instruments available to quantify the physical, functional, and psychological aspects of recovery from traumatic injury. One such instrument is the Short-form or SF-36 questionnaire. This is a widely used measure of health-related quality of life. It consists of 36 questions in eight subscales that assess physical, functional, social, and psychological well-being [1, 2]. The physical and mental component summary scales (PCS and MCS, respectively) are then calculated as composites of the related subscales. Scoring is standardized in the SF-36 using the means and standard deviations from the 1998 US general population. Studies have shown that, despite adequate physical functioning, trauma patients have significantly lower QoL than population norms [3, 4, 5].
The SF-12 contains a subset of 12 items taken from the SF-36. It includes at least one item from the eight health domains of SF-36, but it is shorter and has less response burden. While the SF-36 has been studied in the trauma population, the performance of the SF-12 in these patients is unknown. Therefore, the aim of this study was to compare QoL measured by the SF-36 and SF-12 at 1 and 6 months after traumatic injury. We hypothesized that the SF-12 would provide similar QoL information to the SF-36 in blunt trauma patients.
Section snippets
Study Population
Patients older than 18 years with blunt injury were prospectively identified during review of the daily trauma admission lists from Froedtert Memorial Lutheran Hospital. All patients older than 55 years and those 18-55 years with an Injury Severity Score (ISS) of ≥9 were included. An ISS of at least 9 was chosen to focus on those with moderate and severe injuries. Patients with head or spinal cord injuries were excluded. Eligible patients were enrolled after informed consent was obtained.
Patient Population
The demographic, clinical, and socioeconomic factors for survey responders are shown in Table 1. Three hundred twelve patients were enrolled in the study: 203 total patients responded to the surveys, for a response rate of 65%; 196 had 1-month and 123 had 6-month data available, for response rates of 62.8 and 39.4%.
Comparison of PCS and MCS Scores
Table 2 shows that PCS scores improved over time for both measures. Scores were also significantly lower than population norms at both 1 and 6 months. In addition, the change in the
Discussion
Prior to use of a new instrument to measure QoL, it must be validated. The SF-12 has been validated in general populations and in populations with chronic disease, but to our knowledge has not been previously published as an outcome tool in the trauma population. The trauma population differs from general populations in several ways: it is younger; more predominantly male; has a higher rate of PTSD, depression, poverty, and unemployment; and has a greater degree of functional limitation. The
Acknowledgments
The authors thank Kevin L. Weidner, MS, for assistance with data collection. Funding was provided by CDC Grant R49CCR519614.
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Presented at the 1st Annual Academic, Surgical Congress, San Diego, CA, February 8–11, 2006.