The public health impact of minor injury

Abstract

The mortality and hospital morbidity data usually used to quantify the burden of injury are generally considered to represent only the tip of the iceberg. This article documents the population-based morbidity arising from non-hospitalised injuries and demonstrates the public health importance of this group of injuries. A prospective cohort study was conducted in an Australian population using a sample of injured adults to identify the health outcomes arising from the range of injuries. The total health loss caused by injury experienced by these subjects over the period of injury recovery was calculated and then weighted to provide population estimates. This study has shown that minor injuries are responsible for the greater part of the injury-related health burden in the adult community. Injuries that can be coded as 1 on the Abbreviated Injury Scale account for 80% of the morbidity arising over the first six months after injury and about 75% of the estimated lifetime morbidity. The lifetime estimates of morbidity resulting from injuries not considered serious enough to admit to hospital were of an order of magnitude higher than those that resulted in either death or hospitalisation. Sprains contributed as much to the total morbidity as all other injuries types combined and limb injuries contributed more to the total morbidity than injuries to the more central structures. The results of this study provide a strong argument for the recognition of the public health importance of minor injury. Strategies for the prevention and management of minor injury must be included in national programmes for injury control.

Improved and standardized method for assessing years lived with disability after injury

“…11,27 For the present study, we used data from a study of functional outcomes in injury patients in the Netherlands 13 to generate a disability weight for each of the 39 injury-diagnosis groupings of the EUROCOST classification system. In this Dutch study, data on functional outcome and health-related quality of life were collected, using a generic health-status classification (EQ-5D) and a sample of over 8500 injury patients aged 15 years or older who had minor or severe injury, 2.5, 5 and 9 and 24 months after the patients had attended the emergency department of a hospital in the Netherlands.…”

Recovered? Association between self-perceived recovery and the SF-36 after minor musculoskeletal injuries

“…Minor traffic injuries constitute an important cause of long-term morbidity among people in productive ages [1,2]. The recovery is often puzzlingly protracted [3,4].…”

Inclusion of ‘minor’ trauma cases provides a better estimate of the total burden of injury: Queensland Trauma Registry provides a unique perspective

“…Previous analyses of Queensland and Western Australian data have reported similar percentages of minor injury cases 16,28 . Although these cases were classified as 'minor trauma' in terms of injury severity and threat to life, the injuries sustained were still serious enough to warrant admission to hospital for 24 hours or more for acute treatment, and can include injuries such as fractures to multiple body regions, burns to up to 30% of the body, below-elbow and below-knee amputations, and penetrating injuries with up to 20% blood loss 20 .…”

“…This may, in turn, lead to suboptimal development and implementation of new trauma management policies and practices. Although the importance of considering 'minor' trauma has already been established [14][15][16][17] , there currently exists a paucity of information regarding the magnitude of the effect that excluding minor trauma has on total burden of injury estimates.…”