Citation

Gabbe BJ, Simpson PM, Cameron PA, Ekegren CL, Edwards ER, Page R, Liew S, Bucknill A, de Steiger R. BMJ Open 2015; 5(11): e009907.

Affiliation

Department of Surgery, University of Melbourne, Parkville, Victoria, Australia Epworth Healthcare, Richmond, Victoria, Australia.

Copyright

(Copyright © 2015, BMJ Publishing Group)

DOI

10.1136/bmjopen-2015-009907

PMID

26610765

Abstract

OBJECTIVES: To establish the association between the patient's perception of fault for the crash and 12-month outcomes after non-fatal road traffic injury. SETTING: Two adult major trauma centres, one regional trauma centre and one metropolitan trauma centre in Victoria, Australia. PARTICIPANTS: 2605 adult, orthopaedic trauma patients covered by the state's no-fault third party insurer for road traffic injury, injured between September 2010 and February 2014. OUTCOME MEASURES: EQ-5D-3L, return to work and functional recovery (Glasgow Outcome Scale-Extended score of upper good recovery) at 12 months postinjury.

RESULTS: After adjusting for key confounders, the adjusted relative risk (ARR) of a functional recovery (0.57, 95% CI 0.46 to 0.69) and return to work (0.92, 95% CI 0.86 to 0.99) were lower for the not at fault compared to the at fault group. The ARR of reporting problems on EQ-5D items was 1.20-1.35 times higher in the not at fault group.

CONCLUSIONS: Patients who were not at fault, or denied being at fault despite a police report of fault, experienced poorer outcomes than the at fault group. Attributing fault to others was associated with poorer outcomes. Interventions to improve coping, or to resolve negative feelings from the crash, could facilitate better outcomes in the future.

Language: en