Injury characteristics and EQ-5D as predictors of personal wellbeing after injury

Abstract

Abstract:Objective: A longitudinal study examined the relationships of injury severity, whether the injury was accidental or was caused by an assault, and self-reported EQ-5D soon after injury, with long-term personal wellbeing among participants with a range of injury types and severity.Methods: Interviews with participants recruited in the Prospective Outcomes of Injury Study (POIS) were conducted up to four time points in the 24 months after injury. Key explanatory variables were New Injury Severity Score (NISS), whether the injury was accidental or resulted from assault, and self-reported health status (five EQ-5D questions and a similar question about cognition) reported at three months. The main outcome measure at 24 months was the Personal Wellbeing Index (PWI) (PWI <70='low' wellbeing). Univariate and multivariable analyses examined relationships between explanatory variables and low PWI.Results: Even in a group of people with injuries traditionally regarded as being of mild or moderate anatomical severity, wellbeing continues to be affected for an appreciable time post-injury, with a quarter (27%) of study participants having a low level of personal wellbeing 24 months after their injury. Neither anatomical injury severity nor hospitalisation were predictive of low personal wellbeing. An increased risk of low personal wellbeing was observed in participants whose injury was caused by an intentional assault (rather than accident), and in those who reported problems three months post-injury with EQ-5D self-care, anxiety/depression or cognitive functioning. Conclusions:Identification of such individuals early after an injury is of particular importance and ensuring adequate support services are put in place that encourage re-integration back into work and social networks could help prevent on-going poor wellbeing.

Association of longitudinal changes in patient-reported health status with return to work in the first 2 years after traumatic injury: a prospective cohort study in the Netherlands

“…Several studies have used patient-reported outcomes, such as the EuroQol Five Dimensions (EQ5D), to predict patient outcomes after injury. [15][16][17][18][19][20][21] The EQ5D is a generic instrument that measures patients' perceptions of health status over a wide range of illnesses and covers aspects of physical, mental and social functioning. 22 These studies show that problems with anxiety, depression, cognition, social support or recovery expectations are more important for recovery and well-being than physical problems for instance.…”

“…To our knowledge, no previous studies have examined the pattern of changes in patient-reported health status (EQ5D) during the follow-up after physical injury. A few studies, however, have evaluated patient-reported outcome measures (shortly) after injury as a risk factor for decreased physical and mental functioning, [15][16][17][18][19][20][21] reduced well-being 17 and chronic pain, 16 using a pre-post design. The results of these studies highlight the advantages of using short-term changes in patient-reported outcomes, such as patients' expectations about recovery, 21 health…”

Prospective Outcomes of Injury Study 10 Years on (POIS-10): An Observational Cohort Study

“…POIS-10 will collect detailed person-level data; findings will therefore result in knowledge beyond the reach of administrative datasets alone (e.g., those of ACC, or NZ's Integrated Data Infrastructure). The likelihood of POIS-10 achieving high impact is illustrated by our earlier POIS project, which informed ACC's research strategy, focus on outcomes, and provided knowledge previously unavailable to ACC and others about person-level disability [6,30,31], health [7,48,69], and wellbeing outcomes [33,[42][43][44][45]. Importantly, POIS-10 will provide knowledge about outcomes specifically for Māori [32].…”

“…Self-reported interview data were linked with information from large administrative datasets, including claims e-data from ACC (e.g., earnings-related wage compensation, health professional utilisation, treatment costs, and additional injury events) and injury-related hospitalisations recorded in the Ministry of Health (MoH) national minimum data set (NMDS) [39,40]. Results for the whole cohort, and specifically for Māori [6,[34][35][36][37], revealed key predictors of disability [30,31,41], participation in paid work [36,[42][43][44][45] and unpaid activities [46], other health outcomes including subsequent injury events [40,47], HRQL [46], physical functioning [7], and wellbeing outcomes [33,48] using validated measures. Unlike other longitudinal studies with follow-up rates of 30-50%, POIS achieved a high rate of follow-up at each data collection point, with a 79% follow-up rate at 24 months post-injury.…”

“…HRQoL will be measured using the EQ-5D [56], as in POIS [47,48,63,64]. This assesses health across five key domains of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.…”