Pain, functional independence, and psychological distress as determinants of health-related quality of life in post-acute recovery phase following extremity injury

Background: Extremity trauma is a leading cause of hospital admissions worldwide and significantly impacts post-acute recovery and quality of life. While acute trauma management is well-documented, the post-acute recovery phase remains understudied despite its critical role in long-term outcomes. Identifying determinants of quality of life during this period is essential for optimizing and guiding recovery strategies. This study aimed to investigate correlations between health-related quality of life and key determinants, including demographic characteristics, pain, functional independence and psychological distress, during the post-acute recovery phase following extremity injury. Methods: This cross-sectional study enrolled 70 patients with extremity trauma and was conducted over a year at an outpatient clinic of a tertiary hospital in Taiwan. Pain intensity, functional independence, psychological distress and health-related quality of life were assessed using the numeric pain rating scale, Barthel Index, brief symptom rating scale, and the EuroQoL 5-Dimensions questionnaire, respectively. Multiple linear regression analysis was performed to identify determinants of quality of life. Results: Regression analysis demonstrated significant associations between poorer quality of life and higher pain intensity (β = 0.31, p < 0.001), greater psychological distress (β = 0.20, p = 0.008), older age (β = 0.27, p = 0.049) and injuries from vehicle accidents (β = 0.24, p = 0.016). Conversely, greater functional independence was significantly correlated with improved quality of life (β = −0.57, p < 0.001). Conclusions: This study found significant correlations between health-related quality of life and factors such as pain intensity, psychological distress, functional independence, age and injury mechanism. These findings emphasize the importance of comprehensive care strategies integrating effective pain management, psychological interventions and functional rehabilitation during the post-acute recovery period. Future longitudinal and multi-site studies are recommended to further examine causal relationships and enhance the generalizability of these findings.

Extremity injury; Pain; Stress; Quality of life; Functional status; Regression analysis; Rehabilitation; Cross-sectional studies

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