Prevalence and Predictors of Sub-Acute Phase Disability after Injury among Hospitalised and Non-Hospitalised Groups: A Longitudinal Cohort Study

Abstract

IntroductionTo reduce the burden on injury survivors and their supporters, factors associated with poor outcomes need to be identified so that timely post-injury interventions can be implemented. To date, few studies have investigated outcomes for both those who were hospitalised and those who were not.AimTo describe the prevalence and to identify pre-injury and injury-related predictors of disability among hospitalised and non-hospitalised people, three months after injury.MethodsParticipants in the Prospective Outcomes of Injury Study were aged 18–64 years and on an injury entitlement claims register with New Zealand's no-fault injury compensation insurer, following referral by healthcare professionals. A wide range of pre-injury demographic, health and injury-related characteristics were collected at interview. Participants were categorised as ‘hospitalised’ if they were placed on New Zealand's National Minimum Data Set within seven days of the injury event. Injury severity scores (NISS) and 12 injury categories were derived from ICD-10 codes. WHODAS assessed disability. Multivariable analyses examined relationships between explanatory variables and disability.ResultsOf 2856 participants, 2752 (96%) had WHODAS scores available for multivariable analysis; 673 were hospitalised; 2079 were not. Disability was highly prevalent among hospitalised (53.6%) and non-hospitalised (39.4%) participants, three-months after injury. In both groups, pre-injury disability, obesity and higher injury severity were associated with increased odds of post-injury disability. A range of other factors were associated with disability in only one group: e.g. female, ≥2 chronic conditions and leg fracture among hospitalised; aged 35–54 years, trouble accessing healthcare, spine or lower extremity sprains/dislocations and assault among non-hospitalised.SignificanceDisability was highly prevalent among both groups yet, with a few exceptions, factors associated with disability were not common to both groups. Where possible, including a range of injured people in studies, hospitalised and not, will increase understanding of the burden of disability in the sub-acute phase.

Pacific peoples three months after injury: a comparison of outcomes between Pacific and non‐Pacific participants in a NZ cohort study

“…Many variables have been comprehensively described in other publications reporting outcomes for the larger POIS cohort (n=2,856) or the Pacific cohort (n=239) and are therefore briefly described in this paper. 24,25 All pre-injury and injury-related explanatory variables are described in the order of socio-demographic, health, psychosocial and injury-related characteristics.…”

“…28 Alcohol consumption was assessed using the brief Alcohol Use Disorders Identification Test (AUDIT-C); grouped as 'High', 'Moderate' and 'Low' use. 25,29 Recreational drug use was classified as 'Yes' for those who answered to varying frequencies of use; those who answered 'Never' were classified as 'No'. 25 Information on pre-existing comorbid conditions diagnosed by a health professional were classified as '0', '1' or '≥2' chronic illnesses.…”

“…25,29 Recreational drug use was classified as 'Yes' for those who answered to varying frequencies of use; those who answered 'Never' were classified as 'No'. 25 Information on pre-existing comorbid conditions diagnosed by a health professional were classified as '0', '1' or '≥2' chronic illnesses. 25,30 Self-efficacy was measured using the General Self-Efficacy Scale; scores ≤25 classified as 'Poor' self-efficacy.…”

“…25 Information on pre-existing comorbid conditions diagnosed by a health professional were classified as '0', '1' or '≥2' chronic illnesses. 25,30 Self-efficacy was measured using the General Self-Efficacy Scale; scores ≤25 classified as 'Poor' self-efficacy.…”

Rehabilitation after lower limb injury: development of a predictive score (RALLI score)

“…2,[11][12][13][14][15][16][17] Despite the complexities involved with a heterogeneous trauma population, we believe it is possible to develop a systematic tool to help determine the patient's need for rehabilitation after lower limb injury. Therefore, the aim of our study was to develop a predictive score of inpatient rehabilitation needs after lower limb injury, and the secondary objective was to explore factors associated with acute care LOS.…”