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Association between the number of injuries sustained and 12-month disability outcomes: evidence from the injury-VIBES study.

Gabbe BJ, Simpson PM, Lyons RA, Ameratunga S, Harrison JE, Derrett S, Polinder S, Davie G, Rivara FP - PLoS ONE (2014)

Bottom Line: The adjusted relative risk of a poor functional recovery (GOS-E<7) and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured.Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes.Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Centre for Improvement of Population Health through E-records Research, Swansea University, Swansea, United Kingdom.

ABSTRACT

Objective: To determine associations between the number of injuries sustained and three measures of disability 12-months post-injury for hospitalised patients.

Methods: Data from 27,840 adult (18+ years) participants, hospitalised for injury, were extracted for analysis from the Validating and Improving injury Burden Estimates (Injury-VIBES) Study. Modified Poisson and linear regression analyses were used to estimate relative risks and mean differences, respectively, for a range of outcomes (Glasgow Outcome Scale-Extended, GOS-E; EQ-5D and 12-item Short Form health survey physical and mental component summary scores, PCS-12 and MCS-12) according to the number of injuries sustained, adjusted for age, sex and contributing study.

Findings: More than half (54%) of patients had an injury to more than one ICD-10 body region and 62% had sustained more than one Global Burden of Disease injury type. The adjusted relative risk of a poor functional recovery (GOS-E<7) and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured. Adjusted mean PCS-12 and MCS-12 scores worsened with each additional injury type, or body region, injured by 1.3-1.5 points and 0.5 points, respectively.

Conclusions: Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes. Existing composite measures of anatomical injury severity such as the NISS or ISS, which use up to three diagnoses only, may be insufficient for characterising or accounting for multiple injuries in disability studies. Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.

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Related in: MedlinePlus

Proportion of cases by number of injuries sustained.
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pone-0113467-g001: Proportion of cases by number of injuries sustained.

Mentions: There were 27,840 eligible participants. The proportion of cases by number of injuries sustained using the two definitions of multiple injuries is shown in Fig. 1. Sixty-two percent (17,348) of the cases had sustained more than one GBD 2010 injury type, and 54% (nā€Š=ā€Š15,005) had sustained injuries to more than one ICD-10 body region. The profile of participants by multiple injury status is shown in Table 2. Age ranged from 18-110 years (mean: 52.8 years; SD: 22.6); and 59% were male. The mean age of multiply injured patients was younger than single injury cases, and a higher proportion was male and injured in transport-related events (Table 2). The GBD injury health types with the lowest prevalence of multiple injuries (i.e. the GBD types for which it was most often the case that only one injury diagnosis code was in the record) were dislocation of the hip, knee or shoulder, hip fracture, open wounds and superficial injuries, and fracture of the radius or ulna (S1 Table in S1 File). The GBD injury health types that most often had codes for additional injury types as well as the one recorded as the principal diagnosis (i.e. were most often multiple injury cases) were nerve injury, severe chest injury, spinal cord injury and fracture of the sternum, rib or face.


Association between the number of injuries sustained and 12-month disability outcomes: evidence from the injury-VIBES study.

Gabbe BJ, Simpson PM, Lyons RA, Ameratunga S, Harrison JE, Derrett S, Polinder S, Davie G, Rivara FP - PLoS ONE (2014)

Proportion of cases by number of injuries sustained.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263479&req=5

pone-0113467-g001: Proportion of cases by number of injuries sustained.
Mentions: There were 27,840 eligible participants. The proportion of cases by number of injuries sustained using the two definitions of multiple injuries is shown in Fig. 1. Sixty-two percent (17,348) of the cases had sustained more than one GBD 2010 injury type, and 54% (nā€Š=ā€Š15,005) had sustained injuries to more than one ICD-10 body region. The profile of participants by multiple injury status is shown in Table 2. Age ranged from 18-110 years (mean: 52.8 years; SD: 22.6); and 59% were male. The mean age of multiply injured patients was younger than single injury cases, and a higher proportion was male and injured in transport-related events (Table 2). The GBD injury health types with the lowest prevalence of multiple injuries (i.e. the GBD types for which it was most often the case that only one injury diagnosis code was in the record) were dislocation of the hip, knee or shoulder, hip fracture, open wounds and superficial injuries, and fracture of the radius or ulna (S1 Table in S1 File). The GBD injury health types that most often had codes for additional injury types as well as the one recorded as the principal diagnosis (i.e. were most often multiple injury cases) were nerve injury, severe chest injury, spinal cord injury and fracture of the sternum, rib or face.

Bottom Line: The adjusted relative risk of a poor functional recovery (GOS-E<7) and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured.Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes.Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Centre for Improvement of Population Health through E-records Research, Swansea University, Swansea, United Kingdom.

ABSTRACT

Objective: To determine associations between the number of injuries sustained and three measures of disability 12-months post-injury for hospitalised patients.

Methods: Data from 27,840 adult (18+ years) participants, hospitalised for injury, were extracted for analysis from the Validating and Improving injury Burden Estimates (Injury-VIBES) Study. Modified Poisson and linear regression analyses were used to estimate relative risks and mean differences, respectively, for a range of outcomes (Glasgow Outcome Scale-Extended, GOS-E; EQ-5D and 12-item Short Form health survey physical and mental component summary scores, PCS-12 and MCS-12) according to the number of injuries sustained, adjusted for age, sex and contributing study.

Findings: More than half (54%) of patients had an injury to more than one ICD-10 body region and 62% had sustained more than one Global Burden of Disease injury type. The adjusted relative risk of a poor functional recovery (GOS-E<7) and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured. Adjusted mean PCS-12 and MCS-12 scores worsened with each additional injury type, or body region, injured by 1.3-1.5 points and 0.5 points, respectively.

Conclusions: Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes. Existing composite measures of anatomical injury severity such as the NISS or ISS, which use up to three diagnoses only, may be insufficient for characterising or accounting for multiple injuries in disability studies. Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.

Show MeSH
Related in: MedlinePlus