A cohort study of short-term functional outcomes following injury: the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare

Health and Quality of Life Outcomes

Emma Wyeth¹  Shanthi Ameratunga²  Gabrielle Davie³  Sarah Derrett³  John Langley³ 

[1] Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, 18 Frederick St, Dunedin 9054, New Zealand;Section of Epidemiology & Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 261 Morrin Road, Glen Innes, Auckland 1072, New Zealand;Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, 55 Hanover St, Dunedin 9054, New Zealand

关键词: quality of life;    health status;    outcomes;    EQ-5D;    short-term function;    injury;   

Others  :  826486
DOI  :  10.1186/1477-7525-9-68

 received in 2011-05-16, accepted in 2011-08-18,  发布年份 2011

【 摘 要 】

Background

Injury outcome studies have tended to collect limited pre-injury characteristics, focus on a narrow range of injury types, predictors and outcomes, and be restricted to high threat to life injuries. We sought to identify the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare in determining short-term functional outcomes for a wide range of injuries.

Methods

Study participants (aged 18-64 years inclusive) were those in the Prospective Outcomes of Injury Study, a cohort of 2856 persons who were injured and registered with New Zealand's national no-fault injury insurance agency. All information used in this paper was obtained directly from the participants, primarily by telephone interviews, approximately three months after their injury. The functional outcomes of interest were the five dimensions of the EQ-5D plus a cognitive dimension. We initially examined bivariate relationships between our independent measures and the dependent measures. Our multivariate analyses included adjustment for pre-injury EQ-5D status and time between injury and when information was obtained from participants.

Results

Substantial portions of participants continued to have adverse outcomes approximately three months after their injury. Key pervasive factors predicting adverse outcomes were: being female, prior chronic illness, injuries to multiple body regions, being hospitalized for injury, self-perceived threat to life, and difficulty accessing health services.

Conclusion

Future injury outcome studies should include participants whose injuries are considered 'minor', as judged by acute health service utilization, and also consider a wider range of potential predictors of adverse outcomes.

【 授权许可】

   
2011 Langley et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Van Beeck EF, Larsen CF, Lyons RA, Meerding W-J, Mulder S, Essink-Bot M-L: Guidelines for the conduction of follow-up studies measuring injury-related disability. J Trauma 2007, 62:534-550.
• [2]Derrett S, Langley J, Hokowhitu B, Ameratunga S, Hansen P, Davie G, Wyeth E, Lilley R: Prospective Outcomes of Injury Study. Inj Prev 2009, 15:351.
• [3]Accident Compensation Corporation [http://www.acc.co.nz/] webcite
• [4]Accident Compensation Corporation: Annual Report 2009. Wellington 2009.
• [5]Anonymous: EuroQol--a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 1990, 16:199-208.
• [6]Brooks R: EuroQol: the current state of play. Health Policy 1996, 37:53-72.
• [7]Krabbe PF, Stouthard ME, Essink-Bot ML, Bonsel GJ: The effect of adding a cognitive dimension to the EuroQol multiattribute health-status classification system. J Clin Epidemiol 1999, 52:293-301.
• [8]2006 Census of Population and Dwellings [http:/ / www.stats.govt.nz/ Census/ about-2006-census/ 2006-census-questionnaires.aspx] webcite
• [9]Survey of Working-Aged People in 2000 [http:/ / www.msd.govt.nz/ about-msd-and-our-work/ publications-resources/ monitoring/ living-standards/ living-standards-elsi.html] webcite
• [10]Household Economic Survey 2006-07 printable questionnaires [http://www.stats.govt.nz/] webcite
• [11]2006/07 New Zealand Health Survey Adult Questionnaire [http:/ / www.moh.govt.nz/ moh.nsf/ pagesmh/ 7683/ $File/ nzhs-adult-questionnaire-may08.pdf] webcite
• [12]Ware JE, Snow KK, Kosinski M, Gandek B: SF-36 Health Survey: Manual and Interpretation Guide. Lincoln, RI: QualityMetric Inc; 2000.
• [13]Global Database on Body Mass Index: an interactive surveillance tool for monitoring nutrition transition [http://apps.who.int/bmi/index.jsp] webcite
• [14]Scheier M, Carver C, Bridges M: Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. J Pers Soc Psychol 1994, 67:1063-1078.
• [15]Schwarzer R, Jerusalem M: Generalized Self-Efficacy scale. In Measures in health psychology: A user's portfolio Causal and control beliefs. Edited by Weinman JSW, Johnston M. Windsor, England:: NFER-NELSON; 1995:35-37.
• [16]American Psychiatric Association Committee of Nomenclature and Statistics: Diagnostic and statistical manual of mental disorder-3rd edition (DSM-3). Washington DC: American Psychiatric Association; 1980.
• [17]Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D: Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med 2002, 24:49-58.
• [18]Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR: AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res 2007, 31:1208-1217.
• [19]Sport and Recreation New Zealand: The New Zealand Physical Activity Questionnaires. Wellington: SPARC; 2004.
• [20]Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, Ziv A, Boyko V, Abargel A, Avitzour M, Heruti R: An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev 2002, 8:91-96.
• [21]StataCorp: Stata: Release 11 Statistical Software. College Station: StataCorp; 2009.
• [22]Holbrook TL, Hoyt DB: The impact of major trauma: quality-of-life outcomes are worse in women than in men, independent of mechanism and injury severity. J Trauma 2004, 56:284-290.
• [23]Holtslag HR, van Beeck EF, Lindeman E, Leenen LPH: Determinants of long-term functional consequences after major trauma. J Trauma 2007, 62:919-927.
• [24]Meerding WJ, Looman CWN, Essink-Bot M-L, Toet H, Mulder S, van Beeck EF: Distribution and determinants of health and work status in a comprehensive population of injury patients. J Trauma 2004, 56:150-161.
• [25]Polinder S, van Beeck EF, Essink-Bot ML, Toet H, Looman CWN, Mulder S, Meerding WJ: Functional outcome at 2.5, 5, 9, and 24 months after injury in the Netherlands. J Trauma 2007, 62:133-141.
• [26]Holbrook TL, Hoyt DB, Stein MB, Sieber WJ: Perceived threat to life predicts posttraumatic stress disorder after major trauma: risk factors and functional outcome. J Trauma 2001, 51:287-292. discussion 292-283
• [27]Hepp U, Moergeli H, Stefan B, Bruchhaus-Steinert H, Sensky T: The long-term prediction of return to work following serious accidental injuries: A follow up study. BMC Psychiatry 2011., 11
• [28]Cameron CM, Kliewer EV, Purdie DM, McClure RJ: Long term health outcomes after injury in working age adults: a systematic review. J Epidemiol Community Health 2006, 60:341-344.
• [29]Branas CC, MacKenzie EJ, Williams JC, Schwab CW, Teter HM, Flanigan MC, Blatt AJ, ReVelle CS: Access to trauma centers in the United States. JAMA 2005, 293:2626-2633.
• [30]Rosen H, Saleh F, Lipsitz S, Rogers SO Jr, Gawande AA: Downwardly mobile: the accidental cost of being uninsured.[Erratum appears in Arch Surg. 2010 Jan;145(1):41]. Arch Surg 2009, 144:1006-1011.
• [31]Baker SP, O'Neill B, Haddon W Jr, Long WB: The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974, 14:187-196.
• [32]Holbrook TL, Anderson JP, Sieber WJ, Browner D, Hoyt DB: Outcome after major trauma: discharge and 6-month follow-up results from the Trauma Recovery Project. J Trauma 1998, 45:315-323. discussion 323-314
• [33]Pukk K, Lundberg J, Penaloza-Pesantes RV, Brommels M, Gaffney FA: Do women simply complain more? National patient injury claims data show gender and age differences. Quality Management in Health Care 2003, 12:225-231.
• [34]Capuzzo M, Bertacchini S, Davanzo E, Felisatti G, Paparella L, Tadini L, Alvis R: Health-related quality of life before planned admission to intensive care: memory over three and six months. Health and Quality of Life Outcomes 2010., 8
• [35]Macran S: Recalled versus initial health status: EQ-5D in retrospect. Proceedings of the 19th Plenary Meeting of the EuroQol Group; York, United Kingdom 2002, 369-377.