Citation

Gabbe BJ, Simpson PM, Lyons RA, Ameratunga SN, Harrison JE, Derrett S, Polinder S, Davie GS, Rivara FP. PLoS One 2014; 9(12): e113467.

Affiliation

Departments of Pediatrics and Epidemiology, University of Washington, Seattle, Washington, United States of America.

Copyright

(Copyright © 2014, Public Library of Science)

DOI

10.1371/journal.pone.0113467

PMID

25501651

Abstract

OBJECTIVE: To determine associations between the number of injuries sustained and three measures of disability 12-months post-injury for hospitalised patients.

METHODS: Data from 27,840 adult (18+ years) participants, hospitalised for injury, were extracted for analysis from the Validating and Improving injury Burden Estimates (Injury-VIBES) Study. Modified Poisson and linear regression analyses were used to estimate relative risks and mean differences, respectively, for a range of outcomes (Glasgow Outcome Scale-Extended, GOS-E; EQ-5D and 12-item Short Form health survey physical and mental component summary scores, PCS-12 and MCS-12) according to the number of injuries sustained, adjusted for age, sex and contributing study.

FINDINGS: More than half (54%) of patients had an injury to more than one ICD-10 body region and 62% had sustained more than one Global Burden of Disease injury type. The adjusted relative risk of a poor functional recovery (GOS-E<7) and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured. Adjusted mean PCS-12 and MCS-12 scores worsened with each additional injury type, or body region, injured by 1.3-1.5 points and 0.5 points, respectively.

CONCLUSIONS: Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes. Existing composite measures of anatomical injury severity such as the NISS or ISS, which use up to three diagnoses only, may be insufficient for characterising or accounting for multiple injuries in disability studies. Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.

Language: en