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The association between motor vehicle injuries and health-related quality of life: a longitudinal study of a population-based sample in the United States

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As many as 3 million US residents are injured in traffic-related incidents every year leaving many victims with disabling conditions. To date, limited numbers of studies have examined the effects of traffic-related injuries on self-reported health. This study aims to examine the association between health-related quality of life (HRQOL) and traffic-related injuries longitudinally in a nationally representative sample of US adult population.


This is a longitudinal study of adult participants (age ≥18) from seven panels (2000–2007) of the Medical Expenditure Panel Survey. The dependent variables included the physical and mental components of the SF-12, a measure of self-reported health. The outcome was assessed twice during the follow-up period: round 2 (~4–5 months into the study) and round 4 (~18 months into the study) for 62,298 individuals. Two methods estimate the association between traffic-related injuries and HRQOL: a within person change using paired tests and a between person change using multivariable regression adjusting for age, sex, income and educational level.


Nine hundred and ninety-three participants reported traffic-related injuries during the follow-up period. Compared to their pre-crash HRQOL, these participants lost 2.7 of the physical component score while their mental component did not change. Adjusted results showed significant deficits in the physical component (−2.84, p value = <.001) but not the mental component (−0.07, p value = .83) of HRQOL after controlling for potential confounders.


Traffic injuries were significantly associated with the physical component of HRQOL. These findings highlight the individual and societal burden associated with motor vehicle crash-related disability in the United States.

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  1. Road Safety Status; World Health Organization website. Accessed November 5.

  2. Murray, C. J., Vos, T., & Lozano, R. N. M. (2013). Global burden of disease. (Seatle, 2013) at

  3. National Highway Traffic Safety Administration [NHTSA]. (2003). Motor vehicle traffic crash injury and fatality estimates: 2002 early assessment. (Report No. DOT HS 809 586). Washington, DC: U.S. Department of Transportation.

  4. Shults, R. A., Jones, B. H., Kresnow, M. J., Langlois, J. A., & Guerrero, J. L. (2004). Disability among adults injured in motor-vehicle crashes in the United States. Journal of Safety Research, 35(4), 447–452.

    Article  PubMed  Google Scholar 

  5. Fu, A. Z., Qiu, Y., Radican, L., & Luo, N. (2011). Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States. Quality of Life Research, 20(6), 825–832.

    Article  PubMed  Google Scholar 

  6. Ringdal, M., Plos, K., Lundberg, D., Johansson, L., & Bergbom, I. (2009). Outcome after injury: Memories, health-related quality of life, anxiety, and symptoms of depression after intensive care. Journal of Trauma, 66, 1226–1233.

    Article  PubMed  Google Scholar 

  7. Holbrook, T. L., Anderson, J. P., Sieber, W. J., Browner, D., & Hoyt, D. B. (1999). Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. Journal of Trauma, 46, 765–771.

    Article  CAS  PubMed  Google Scholar 

  8. Michaels, A. J., Michaels, C. E., Smith, J. S., Moon, C. H., Peterson, C., & Long, W. B. (2000). Outcome from injury: General health, work status, and satisfaction 12 months after trauma. Journal of Trauma, 48, 841–848.

    Article  CAS  PubMed  Google Scholar 

  9. Holtslag, H. R., Van Beeck, E. F., Lindeman, E., & Leenen, L. P. (2007). Determinants of long-term functional consequences after major trauma. Journal of Trauma, 62, 919–927.

    Article  PubMed  Google Scholar 

  10. Aitken, L. M., Davey, T. M., Ambrose, J., Connelly, L. B., Swanson, C., & Bellamy, N. (2007). Health outcomes of adults 3 months after injury. Injury, 38, 19–26.

    Article  PubMed  Google Scholar 

  11. Christensen, M. C., Banner, C., Lefering, R., Vallejo-Torres, L., & Morris, S. (2011). Quality of life after severe trauma: Results from the global trauma trial with recombinant factor VII. Journal of Trauma, 70, 1524–1531.

    Article  PubMed  Google Scholar 

  12. Black, J. A., Herbison, G. P., Lyons, R. A., Polinder, S., & Derrett, S. (2011). Recovery after injury: An individual patient data meta-analysis of general health status using the EQ-5D. Journal of Trauma, 71, 1003–1010.

    Article  PubMed  Google Scholar 

  13. Alonso, J., Ferrer, M., Gandek, B., Ware, J. E., Jr, Aaronson, N. K., Mosconi, P., et al. (2004). Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) project. Quality of Life Research, 13(2), 283–298.

    Article  PubMed  Google Scholar 

  14. Haley, W. E., Roth, D. L., Kissela, B., Perkins, M., & Howard, G. (2011). Quality of life after stroke: A prospective longitudinal study. Quality of Life Research, 20(6), 799–806.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Read, K. M., Kufera, J. A., Dischinger, P. C., Kerns, T. J., Ho, S. M., Burgess, A. R., et al. (2004). Life-altering outcomes after lower extremity injury sustained in motor vehicle crashes. Journal of Trauma, 57(4), 815–823.

    Article  PubMed  Google Scholar 

  16. Brasel, K. J., Deroon-Cassini, T., & Bradley, C. T. (2010). Injury severity and quality of life: Whose perspective is important? Journal of Trauma, 68(2), 263–268.

    Article  PubMed  Google Scholar 

  17. Andersen, D., Ryb, G., Dischinger, P., Kufera, J., & Read, K. (2010). Self-reported health indicators in the year following a motor vehicle crash: A comparison of younger versus older subjects. Annals of Advances in Automotive Medicine, 54, 359–367.

    PubMed Central  PubMed  Google Scholar 

  18. Pons-Villanueva, J., Rodríguez de Armenta, M. J., Martínez-González, M. A., & Seguí-Gómez, M. D. (2011). Longitudinal assessment of quality of life and its change in relation to motor vehicle crashes: The SUN (Seguimiento Universidad de Navarra) Cohort. Journal of Trauma, 70(5), 1072–1077.

    Article  PubMed  Google Scholar 

  19. Ameratunga, S. N., Norton, R. N., Connor, J. L., Robinson, E., Civil, I., Coverdale, J., Bennett, D., & Jackson, R. T. (2006). A population-based cohort study of longer-term changes in health of car drivers involved in serious crashes. Annals of Emergency Medicine, 48(6), 729–36. Epub 2006 Sep 25.

    Google Scholar 

  20. Nyman, J. A., Barleen, N. A., & Kirdruang, P. (2008). Quality-adjusted life years lost from nonfatal motor vehicle accident injuries. Medical Decision Making, 28(6), 819–828.

    Article  PubMed  Google Scholar 

  21. U.S. Department of Health and Human Services. (2012). Healthy People 2020; Accessed May 31, 12:

  22. Agency for Healthcare Research and Quality web site. Medical Expenditure Panel Survey. Available from: Accessed October 15, 2011.

  23. Ware, J., et al. (1996). How to score the SF-12 physical and mental health summary scales, 2nd ed. Lincoln RI: Quality Metric, Inc., and the Health Assessment Lab.

  24. Ware, J., Kosinski, M., Turner-Bowker, D., & Gandek, B. (2002). SF12v2: How to score version 2 of the SF-12 health survey. Lincoln, RI: QualiyMetric Incorporated.

    Google Scholar 

  25. The EuroQol Group. Available at: Accessed November 11, 2011.

  26. McDowell, I., & Newell, C. (1996). Measuring health: A guide to Rating Scales and Questionnaires (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  27. Thomas, D. R., & Rao, J. N. K. (1987). Small sample comparison of level and power for simple goodness-of-fit statistics under cluster sampling. Journal of American Statistical Association, 82, 630–636.

    Article  Google Scholar 

  28. Holbrook, T. L., Hoyt, D. B., Coimbra, R., Potenza, B., Sise, M. J., Sack, D. I., et al. (2007). Trauma in adolescents causes long-term marked deficits in quality of life: Adolescent children do not recover preinjury quality of life or function up to two years postinjury compared to national norms. Journal of Trauma, 62(3), 577–583.

    Article  PubMed  Google Scholar 

  29. Holbrook, T. L., & Hoyt, D. B. (2004). The impact of major trauma: Quality-of-life outcomes are worse in women than in men, independent of mechanism and injury severity. Journal of Trauma, 56(2), 284–290.

    Article  PubMed  Google Scholar 

  30. Ellis, J. J., Eagle, K. A., Kline-Rogers, E. M., & Erickson, S. R. (2005). Validation of the EQ-5D in patients with a history of acute coronary syndrome. Current Medical Research and Opinion [0300-7995] Ellis 21(8), 1209–1216.

    Google Scholar 

  31. Sullivan, P. W., & Ghushchyan, V. (2006). Preference-based EQ-5D index scores for chronic conditions in the United States. Medical Decision Making, 26(4), 410–420.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Ponsford, J., Hill, B., Karamitsios, M., & Bahar-Fuchs, A. (2008). Factors influencing outcome after orthopedic trauma. Journal of Trauma, 64(4), 1001–1009.

    Article  PubMed  Google Scholar 

  33. Yang, Z., Lowe, A. J., de la Harpe, D. E., & Richardson, M. D. (2010). Factors that predict poor outcomes in patients with traumatic vertebral body fractures. Injury, 41(2), 226–230. Epub 2009 Nov 3.

    Google Scholar 

  34. Hu, X.-B., Feng, Z., Fan, Y.-C., Xiong, Z.-Y., & Huang, Q.-W. (2012). Health-related quality-of-life after traumatic brain injury: A 2-year follow-up study in Wuhan, China. Brain Injury, 26(2), 183–187.

    Article  PubMed  Google Scholar 

  35. Sampalis, S., Liberman, M., Davis, L., Angelopoulos, J., Longo, N., Sampalis, F., et al. (2006). Functional status and quality of life in survivors of injury treated at tertiary trauma centers: What are we neglecting? Journal of Trauma, 60(4), 806–813.

    Article  PubMed  Google Scholar 

  36. Jia, H., & Lubetkin, E. I. (2005). The impact of obesity on health-related quality-of-life in the general adult US population. Journal of Public Health (Oxford), 27(2), 156–164. Epub 2005 Apr 8.

    Google Scholar 

  37. Heeringa, S., West, B., & Berglund, P. (2010). Applied survey data analysis (pp. 140–144). Boca Raton: Chapman & Hall/CRC, Taylor & Francis Group.

  38. Edelman, D., Olsen, M. K., Dudley, T. K., et al. (2002). Impact of diabetes screening on quality of life. Diabetes Care, 25, 1022–1026.

    Article  PubMed  Google Scholar 

  39. Cheak-Zamora, N. C., Wyrwich, K. W., & McBride, T. D. (2009). Reliability and validity of the SF-12v2 in the Medical Expenditure Panel Survey. Quality Life Research, 18, 727–735.

    Article  Google Scholar 

  40. Khanna, D., Maranian, P., Palta, M., Kaplan, R. M., Hays, R. D., Cherepanov, D., et al. (2011). Health-related quality of life in adults reporting arthritis: Analysis from the National Health Measurement Study. Quality of Life Research, 20(7), 1131–1140.

    Article  PubMed Central  PubMed  Google Scholar 

  41. MacKenzie, E. J., McCarthy, M. L., Ditunno, J. F., Forrester-Staz, C., Gruen, G. S., Marion, D. W., et al. (2002). Pennsylvania Study Group on Functional Outcomes Following Trauma. Using the SF-36 for characterizing outcome after multiple trauma involving head injury. Journal of Trauma, 52(3), 527–534.

    Article  PubMed  Google Scholar 

  42. Tøien, K., Bredal, I. S., Skogstad, L., Myhren, H., & Ekeberg, O. (2011). Health related quality of life in trauma patients. Data from a one-year follow up study compared with the general population. Scand Journal of Trauma Resuscitation Emergency Medicine, 19, 22.

    Article  Google Scholar 

  43. Kiely, J. M., Brasel, K. J., Guse, C. E., & Weigelt, J. A. (2006). Correlation of SF-12 and SF-36 in a trauma population. Journal of Surgical Research, 132(2), 214–218.

    Article  PubMed  Google Scholar 

  44. Langley, J., Derrett, S., Davie, G., Ameratunga, S., & Wyeth, E. (2011). 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 Qual Life Outcomes, 9, 68.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Glymour, M. M., Weuve, J., Berkman, L. F., Kawachi, I., & Robins, J. M. (2005). When is baseline adjustment useful in analyses of change? An example with education and cognitive change. American Journal of Epidemiology, 162(3), 267–278.

    Article  PubMed  Google Scholar 

  46. Vittinghoff, E., Glidden, D. V., Shiboski, S. C., & Charles, E. (2005). McCulloch regression methods in biostatistics: Linear, logistic, survival, and repeated measures models (pp. 33, 263–266). New York: Springer Science + Business Media Inc.

  47. Holder, Y., Peden, M., Krug, E. G., et al. (2004). Injury surveillance guidelines. Geneva, Switzerland: World Health Organization.

    Google Scholar 

  48. Haider, A. H., Chang, D. C., Haut, E. R., Cornwell, E. E., I. I. I., & Efron, D. T. (2009). Mechanism of injury predicts patient mortality and impairment after blunt trauma. Journal of Surgical Research, 153, 138–142.

    Article  PubMed  Google Scholar 

  49. Robertson, L. (2007). Injury epidemiology, (3rd ed., p. 14). New York: Oxford University Press.

  50. Overgaard, M., Høyer, C. B., & Christensen, E. F. (2011). Long-term survival and health-related quality of life 6 to 9 years after trauma. Journal of Trauma, 71(2), 435–441.

    Article  PubMed  Google Scholar 

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Correspondence to Suliman Alghnam.

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Alghnam, S., Palta, M., L. Remington, P. et al. The association between motor vehicle injuries and health-related quality of life: a longitudinal study of a population-based sample in the United States. Qual Life Res 23, 119–127 (2014).

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