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Predictors of health-related quality of life after non-catastrophic injury sustained in a road traffic crash - 20/07/20

Doi : 10.1016/j.rehab.2019.10.001 
Bamini Gopinath a, , Jagnoor Jagnoor a, b, Annette Kifley a, Michael Dinh c, Ashley Craig a, Ian D. Cameron a
a John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia 
b The George Institute for Global Health, University of New South Wales, Sydney, Australia 
c Department of Trauma Services, Royal Prince Alfred Hospital, Sydney, Australia 

Corresponding author at: John Walsh Centre for Rehabilitation Research, Kolling Institute, Corner Reserve Road & First Avenue, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.John Walsh Centre for Rehabilitation Research, Kolling InstituteCorner Reserve Road & First Avenue, Royal North Shore HospitalSt LeonardsNSW 2065Australia

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Highlights

Quality of life scores improved 12 months after a non-catastrophic injury.
Psychological distress and trauma-related distress influenced quality of life.
Demographic factors and pain severity were also associated with quality of life.

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Abstract

Background

Health-related quality of life (HRQoL) is an important patient-reported outcome that warrants greater attention in individuals who sustained a non-catastrophic injury in a road traffic crash. Additional robust data on HRQoL outcomes after a non-catastrophic injury are needed to effectively identify potential targets for studies of tertiary prevention of poor recovery after a crash.

Objective

We assessed the association between non-catastrophic road traffic crash injuries and HRQoL and factors that independently affect long-term HRQoL.

Methods

In this inception cohort study, injured participants (≥17 years old) were identified from various sources including hospital emergency departments by a medical examination by a registered healthcare professional in New South Wales (Australia) and followed up after 12 months. HRQoL was measured by the European Quality of Life–5 Dimensions (EQ-5D-3L) and Medical Outcomes Survey Short Form 12 items (SF-12). A range of socio-demographic, pre-injury health, psychological, and injury-related factors were considered potential predictors of HRQoL in regression analyses.

Results

Among 2019 individuals identified, 1201 (59.5%) were followed up after 12 months. HRQoL significantly improved between baseline and 12-month follow-up: EQ-5D-3L summary score (0.41-unit difference); SF-12 physical component summary score (PCS; 13.6-unit difference) and mental component summary score (MCS; 3.5-unit difference). Over 12 months, HRQoL score was lower for people claiming compensation than others (P<0.0001). Key predictors of better 12-month EQ-5D-3L summary score and visual analogue scale score for pain were age, not claiming compensation, reduced body mass index, less pain severity, less pain-related disability, and less general psychological distress. Significant predictors of SF-12 PCS score were injury to the neck (P=0.02) or head or face (P=0.01), being a driver or passenger at the time of the crash (P<0.0001), hospital admission (P<0.0001) and pain severity (P<0.0001). Baseline variables associated with 12-month SF-12 MCS scores were head or face injury (P=0.02), pre-injury health (P=0.04), pre-injury psychological conditions (P=0.04), trauma-related distress (P=0.0002) and general psychological distress (P<0.0001).

Conclusions

A wide spectrum of biopsychosocial factors contribute to HRQoL after a road traffic crash injury. These epidemiological data are potentially important because they could identify potential targets for studies of tertiary prevention of persistently poor HRQoL after such an injury.

Le texte complet de cet article est disponible en PDF.

Keywords : Health-related quality of life, Non-catastrophic injury, Road traffic crash, Cohort study.


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Vol 63 - N° 4

P. 280-287 - juillet 2020 Retour au numéro
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