Two years after injury: prevalence and early post-injury predictors of ongoing injury-related problems

Wilson, Suzanne; Davie, Gabrielle; Derrett, Sarah

doi:10.1007/s11136-017-1521-9

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…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.…”

Section: Open Accessmentioning

confidence: 99%

“…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…”

Section: Eq5d Longitudinal Trajectory and Rtwmentioning

confidence: 99%

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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

et al. 2021

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ObjectivesTo determine the prognostic value of time driven changes in health status on return to work (RTW) in the first 2 years after traumatic injury.DesignA prospective longitudinal cohort study. All patient-reported outcomes were measured at 1 week, 1, 3, 6, 12 and 24 months after injury.SettingTen participating hospitals in the Netherlands.ParticipantsEmployed adult clinical injury patients admitted to the hospital between August 2015 and November 2016 (N=1245 patients).Main outcome measuresData about (first) RTW were used from the patient-reported questionnaires (1=yes, 0=no). RTW was measured as the first time a patient started working after hospital admission. Time until RTW was calculated in weeks. Health status was measured with the EuroQol Five Dimensions-3 Levels (EQ5D) including a dimension to measure cognition.ResultsAt 24 months, 88.5% (n=1102) of the patients had returned to work. The median time to RTW was 6.6 weeks (IQR: 2–13). Patients’ health status was found to be an independent prognostic factor for RTW: a 0.1-unit increase in EQ5D (scale 0–1) translated into RTW being four times more likely (95% CI 1.60 to 11.94). Patients who had moderate or severe problems (0=no problems, 1=moderate or severe problems) with mobility (HR 0.91, 95% CI 0.84 to 0.98), anxiety/depression (HR 0.86, 95% CI 0.80 to 0.91), usual activities (HR 0.91, 95% CI 0.83 to 0.98), self-care (HR 0.90, 95% CI 0.79 to 0.99) and cognition (HR 0.90, 95% CI 0.85 to 0.94) were significantly less likely to RTW compared with patients with no problems.ConclusionIncreased self-reported health status over time is associated with a higher likelihood of RTW, independent of baseline risk factors, such as injury severity or education. Knowledge on patient-reported outcomes can contribute to the development of tailored RTW treatments. Furthermore, patient-reported outcomes could be used as monitoring tool to guide postinjury care in the clinical setting and RTW process.Trial registration numberNCT02508675; Results.

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Section: Open Accessmentioning

confidence: 99%

Section: Eq5d Longitudinal Trajectory and Rtwmentioning

confidence: 99%

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

et al. 2021

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“…According to the literature, early recognition, treatment and monitoring of psychological problems improve non-fatal outcomes after trauma [16,[63][64][65][66]. Therefore, early screening and interventions to reduce symptoms of post-traumatic stress should be part of standard care.…”

Section: Implications For Health-carementioning

confidence: 99%

Health status and psychological outcomes after trauma: A prospective multicenter cohort study

et al. 2020

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“…Over the last several decades many studies have shown improved mortality rates in trauma centres [1][2][3][4][5][6][7][8][9]. These patients might be at risk of short and long-term disabilities [10][11][12][13][14][15]. Two years after injury only 23% of the severely injured patients returned to their pre-injury level of function and 70% resumed prior employment status [16,17].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal analysis of health status the first year after trauma in severely injured patients

Havermans¹,

Jongh²,

Munter

et al. 2020

Scand J Trauma Resusc Emerg Med

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Purpose: While survival rates after a trauma are increasing a considerable part of the trauma population are still at risk for both short and long term disabilities. Little is known about prognostic factors over time after a severe trauma. The aim of the present prospective cohort study was to examine trauma and patient related prognostic factors for a lower health status over time after a severe trauma. Methods: A multicentre prospective observational cohort study was conducted. Adult trauma patients with severe injuries (ISS ≥ 16) were included from August 2015 until November 2016 if admitted to one of the hospitals in Noord-Brabant (the Netherlands). Outcome measure was health status, measured by the EuroQol-5D (EQ-5D utility and EQ-Visual analogue scale) and the Health Utilities Index (HUI2 and HUI3) one week and one, three, six, and twelve months after injury. Patient and trauma characteristics were analysed as prognostic factors with linear mixed models. The effect of each prognostic factor over time was analysed by adding the interaction term between the prognostic factor and time point in a multivariable linear mixed model, adjusted for confounders. Additionally, the risk factors for problems in the EQ-5 dimensions of HS and cognition were analysed. Results: In total 239 severely injured patients participated. Pre-injury health status, hospital length of stay, ISS and comorbidities were significant prognostic factors for a lower health status. A younger age and extremity injury were prognostic factors for a lower health status until one month after trauma and unemployment before trauma and comorbidities six until twelve months after trauma. In the EQ-5 dimensions 44.1% remained problems in mobility, 15.3% in self-care, 46.4% in activity, 53.3% in pain, 32.5% in anxiety and 35.7% in cognition. Conclusions: Lower pre-injury health status, longer hospital length of stay, higher ISS, and comorbidities were significant prognostic factors for a lower health status during one year after a severe injury. A younger age and an extremity injury were short-term prognostic factors and unemployment before trauma and comorbidities were long-term prognostic factors. Even after twelve months patients in our population reported more problems in all EQ-5D dimensions when compared to the Dutch reference population.

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Two years after injury: prevalence and early post-injury predictors of ongoing injury-related problems

Cited by 14 publications

References 26 publications

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

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

Health status and psychological outcomes after trauma: A prospective multicenter cohort study

Longitudinal analysis of health status the first year after trauma in severely injured patients

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