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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

Adjusted difference in mean MCS-12 and PCS-12 scores by number of injuries sustained (adjusted for age, gender and data source (study)).
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pone-0113467-g002: Adjusted difference in mean MCS-12 and PCS-12 scores by number of injuries sustained (adjusted for age, gender and data source (study)).

Mentions: Valid PCS-12 and MCS-12 scores were collected for 56.4% of participants. The proportion of multiply injured patients was similar for the patients followed-up (57.1%) and those lost to follow-up (51.1%) (S2 Table in S1 File). The adjusted mean PCS-12 score declined significantly as the number of injuries sustained increased (Fig. 2). While the adjusted mean MCS-12 score for each of the multiple injury categories was lower than the single injury group, the degree of decline largely plateaued after more than three injuries (Fig. 2). For each additional 2010 GBD injury type or ICD-10 body region injured, the adjusted mean PCS-12 score decreased 1.5 (95% CI: 1.3, 1.6) or 1.3 (95% CI: 1.2, 1.5) points, respectively. The adjusted mean MCS-12 score decreased by 0.5 (95% CI: 0.4, 0.6) points for each additional injury sustained, regardless of definition used.


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)

Adjusted difference in mean MCS-12 and PCS-12 scores by number of injuries sustained (adjusted for age, gender and data source (study)).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0113467-g002: Adjusted difference in mean MCS-12 and PCS-12 scores by number of injuries sustained (adjusted for age, gender and data source (study)).
Mentions: Valid PCS-12 and MCS-12 scores were collected for 56.4% of participants. The proportion of multiply injured patients was similar for the patients followed-up (57.1%) and those lost to follow-up (51.1%) (S2 Table in S1 File). The adjusted mean PCS-12 score declined significantly as the number of injuries sustained increased (Fig. 2). While the adjusted mean MCS-12 score for each of the multiple injury categories was lower than the single injury group, the degree of decline largely plateaued after more than three injuries (Fig. 2). For each additional 2010 GBD injury type or ICD-10 body region injured, the adjusted mean PCS-12 score decreased 1.5 (95% CI: 1.3, 1.6) or 1.3 (95% CI: 1.2, 1.5) points, respectively. The adjusted mean MCS-12 score decreased by 0.5 (95% CI: 0.4, 0.6) points for each additional injury sustained, regardless of definition used.

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