Two years after injury: prevalence and early post-injury predictors of ongoing injury-related problems
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To determine, in a cohort with injuries classified anatomically as mainly minor or moderate and for which only 25% were hospitalised acutely, the prevalence of ongoing problems attributed by participants to their injury 2 years prior, and to examine whether three-month post-injury experiences and expectations predict such problems.
Participants (N = 2231; 18–64 years at injury) were those in the Prospective Outcomes of Injury Study who completed the initial three-month and final two-year interviews. The outcome measure was whether participants reported ongoing injury-related problems at 2 years. Possible early post-injury predictors were identified from the first interview; pre-injury and injury-related potential confounders from the first interview, insurer records and hospital discharge records. Multivariable models estimated relative risks.
Almost half the participants reported injury-related problems at 2 years. Participants reporting non-recovery at 3 months were more likely than those reporting recovery to have ongoing problems at 2 years, ranging from participants expecting to get better soon [adjusted RR 2.2, 95% CI (1.7,2.8)) to those expecting to never get better (aRR 3.1, 95% CI (2.4,4.0)]. Several three-month post-injury experiences also predicted ongoing problems at 2 years. Participants at highest risk included those with extreme pain [aRR 2.1, 95% CI (1.7,2.5)], and less involvement in usual activities [aRR 1.7, 95% CI (1.5,1.9)].
Findings indicate that early post-injury characteristics predict longer-term recovery among this cohort, most of who were not classified as seriously injured, and provide guidance for future studies on interventions to reduce poor outcome prevalence, particularly focussing on pain management and enabling return to independence and social participation.
KeywordsLongitudinal cohort study Outcome of injury Patient-reported outcomes Risk factors Recovery
The Prospective Outcomes of Injury Study was funded by the Health Research Council of New Zealand (2007–2013), and co-funded by the Accident Compensation Corporation, New Zealand (2007–2010). The views and conclusions expressed in this paper are the authors’ and may not reflect those of the funders. The authors are most grateful to the study participants for sharing their information with us.
Compliance with ethical standards
Conflict of interest
SD is a member of the EuroQol Group Scientific Committee which is responsible for one of the measures used in this study, the EQ-5D. SW and GD declare that they have no conflict of interest.
The Prospective Outcomes of Injury Study received ethical approval from the New Zealand Health and Disability Multi-Region Ethics Committee (MEC/07/07/093).
Informed consent was obtained from all participants in the Prospective Outcomes of Injury Study.
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