Prevalence of poor outcomes soon after injury and their association with the severity of the injury

Abstract

Little is known of injury outcomes among non-hospitalised injured populations. This study examined the occurrence of poor outcomes 3 months after injury among the 2856 participants in the Prospective Outcomes of Injury Study, most of whom had sustained injuries considered of minor severity (by injury severity scoring) and had not received treatment at a hospital facility. The prevalence of poor outcomes was high across all health, physical functioning and social functioning domains and expectation characteristics examined, including for those participants with the 'least severe' injuries. Approximately half of the cohort reported experiencing moderate to high pain or psychological distress and reduced social participation, and three-quarters did not consider themselves recovered. Our findings demonstrate that, to obtain an accurate understanding of injury burden, injury outcome research should not focus only on those injured persons who are hospitalised.

A few seconds to have an accident, a long time to recover: Consequences for road accident victims from the ESPARR cohort 2 years after the accident

“…In a Swedish study (Andersson et al, 1997), nearly 7% has NISS ≥ 9 (8 of 112; subjects were interviewed 2 years after their accident): this low rate may be due to the subjects being randomly selected. In Australia, only 1% of participants (35 out of 2856 subjects) in the POIS cohort (Wilson et al, 2013) has NISS ≥ 16. Furthermore, the sampling strategy was taken into account in the present analysis.…”

Severity of injury can be assessed on a number of dimensions

“…Contrary to what Barry argues1 the paper presenting results from the Prospective Outcomes of Injury Study (POIS)2 is not a contradiction of arguments Colin Cryer and I have advanced against seeking to prevent all injuries irrespective of severity 3 4…”

“…The methods section of POIS paper clearly states that severity of injury was assessed according to the New Injury Severity Score 2. This is a threat to life assessment.…”

“…As stated in the paper by Wilson et al ,2 prior to POIS's inception, the few injury outcome studies that had been undertaken have recruited participants from those perceived or assessed to have moderate to high threat to life injuries. Typically study participants were recruited from those seeking hospital treatment (usually inpatients) in the acute phase of their injury.…”

Delightful contradictions!

“…John Langley1 has managed to demolish (or so he thinks) my brilliant arguments in support of preventing all injuries regardless of severity,2 and almost simultaneously, in an online ahead of print article,3 provides strong new evidence in support of my position. His online paper concludes, “… this study shows that people with anatomically less severe injuries can be experiencing poor outcomes across a range of domains 3 months after their injury and that a substantial proportion do not consider themselves to have fully recovered.…”