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Patient-reported outcome measures within European cohorts of severely injured patients: a systematic review and meta-analysis.

Laura van den Berg·Jan C van Ditshuizen·Pieter H C Leliefeld·Dennis den Hartog·Georgios F Giannakópoulos·Michiel H J Verhofstad·Mariska A C de Jongh
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Abstract

PURPOSE: Severe injury affects multiple health-related domains, yet comprehensive European data on patient-reported outcomes remain limited. This systematic review and meta-analysis evaluates patient-reported outcome measures (PROMs) use and outcomes in severely injured European cohorts. METHODS: A systematic search of four databases up to October 14, 2025, identified European studies from 2000 onward reporting PROMs in severely injured patients. Severe injury was defined as an Injury Severity Score ≥ 16, Glasgow Coma Scale ≤ 8, intensive care unit admission, spinal cord injury, traumatic amputations, or pelvic fractures. Two reviewers independently screened records, with disagreements resolved by a third reviewer. Meta-analysis was performed when ≥ 3 studies reported comparable PROMs at similar follow-up timepoints. RESULTS: Of 2,479 studies, 119 were included. Most cohorts originated from the Netherlands (26%), Norway (18%), and Germany (16%). General severely injured cohorts were most frequently studied (61%), followed by traumatic brain injury (17%), and spinal cord injury (15%). In total, 94 PROMs were used across 277 follow-up timepoints. Health-related quality of life was assessed most frequently (63%), after that anxiety/depression (14%), post-traumatic stress (9%), and social functioning (6%). At one year follow-up, the pooled EuroQol-5D-3 L index score was 0.70 (95% CI 0.62-0.77) and VAS score was 68 (95% CI 60-75), indicating persistent impairment compared to population norms. CONCLUSION: Severely injured patients show persistent impairments with incomplete restoration of pre-injury functioning. Despite increased PROMs use, heterogeneity in selection and outcome reporting limits comparability, underscoring the need for standardised PROM assessment to improve outcome evaluation after severe injury.

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HumansPatient Reported Outcome MeasuresEuropeQuality of LifeWounds and InjuriesInjury Severity ScorePatient-reported outcomesPhysical injuryPsychosocial factorsQuality of lifeSevere traumaJournal ArticleSystematic ReviewMeta-AnalysisReview

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Laura van den Berg, Jan C van Ditshuizen, Pieter H C Leliefeld, Dennis den Hartog, Georgios F Giannakópoulos, Michiel H J Verhofstad, Mariska A C de Jongh. 2026-09-04. Patient-reported outcome measures within European cohorts of severely injured patients: a systematic review and meta-analysis.. https://doi.org/10.1007/s00068-026-03325-y

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Europe subjectHumans subjectJournal Article subjectJournal Article; Systematic Review; Meta-Analysis; Review resourceMeta-Analysis subjectSystematic reviews study

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