Health status and quality of life among road users with permanent medical impairment several years after the crash

Abstract

Objective: Improvements in road infrastructure and vehicle safety have been achieved in many countries during the last decades. As the number of fatalities have dropped, the consequences of non-fatal injuries have been brought into focus. Therefore, the objective was to investigate selfreported health status and health-related quality of life several years after the crash for road-users that sustained injuries resulting in permanent medical impairment (PMI). Methods: A self-administered questionnaire using instruments to measure if health, health-related quality of life and physical activity had been affected by the crash, were used. The injured roadusers were identified from insurance policy holders of the Folksam Insurance Group. The response rate was 29%, a total of 2078 responses were received from the 7174 road-users with PMI that received the questionnaire. Results: In total 85% were still suffering from the injuries several years after the crash (8-18 year after the crash). Furthermore, road-users with injuries to the spine were having highest pain intensity. Older road-users had poorer self-reported health status than younger road-users. Although, younger road-users had the greatest change in physical activity when comparing before and after the crash. Before the crash in total 63% were physically active while only 34% after the crash. The higher the PMI the higher it affected health several years after the crash. Conclusions: The Swedish definition of serious injury, an injury leading to PMI, was found to correlate with self-reported health loss; 85% of the injured road-users reported that they still had remaining symptoms several years after the accident. The injured body region leading to PMI after an accident can vary from the body regions reported to cause long-term health loss. It was found that the higher the degree of PMI the higher the health loss. Sustaining a PMI regardless severity and injured body region has the same effects on general health for men and women. Sustaining a PMI will both lower the health-related quality of life and physical activity after the crash compared to before.

Sickness absence and disability pension after road traffic accidents, a nationwide register-based study comparing different road user groups with matched references

“…More bicyclists had injuries to the upper extremities, while head injuries and injuries to the ‘vertebral column and spinal cord’, and ‘torso’ were more common among the car occupants. This is also in line with previous findings [ [5] , [6] , [7] , [8] , 15 ]. Other road users (including mostly motorcyclists) had a lower proportion of injuries to the head, face, and neck in the present study.…”

Sex-related disparities in vehicle crash injury and hemodynamics

“…For male patients, injury frequencies were ranked the same as female patients (Figure 1), with the most frequent being pelvis (bony; 35.6%) followed by spleen (16.8%), liver (12.5%), small intestine (12.0%), kidney (8.0%), large intestine (5.94%), pancreas (5.71%), pelvis (organ; 3.1%), and stomach (<1%). There were no significant sex differences in proportions of injury by region [χ 2 (64) = 72.0, p = 0.23].…”

“…Atwood et al (1) demonstrated greater relative fatality risk (on average, 2.9% higher fatality risk for female front row occupants vs. male) for females in vehicles with the newest generation of safety equipment, but the differences between male and female occupants' fatality risk fluctuate across age groups. Stigson et al (2) report a greater risk of permanent medical impairment (PMI) in females compared to males, and countermeasures designed to mitigate this risk (specific to "neck" region injury, which is the region most associated with PMI) were not equally effective in men and women (3). Nutbeam et al (4) found that female patients were more frequently entrapped after crash, and that entrapped male and female patients had differing injury patterns.…”

Fall- and collision-related injuries among pedestrians in road traffic environment – A Swedish national register-based study

“…This measure has been developed to estimate the risk for a patient of suffering a medical impairment at a specific level 1-3 years after the accident, based on the body part and the severity from the AIS classification of injuries using the method described by Malm et al (2008). The RPMI metric has been validated in relation to sick leave and perceived quality of life (Elrud et al, 2019;Stigson et al, 2020). The Swedish Transport Administration defines a serious injury in the road traffic environment as an injury that leads to a PMI of above 1% (PMI1+) and a very serious injury as an injury that leads to a PMI of above 10% (PMI10+) (Trafikverket, 2020).…”