A cohort study of short-term functional outcomes following injury: the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare

BACKGROUND: Injury outcome studies have tended to collect limited pre-injury characteristics, focus on a narrow range of injury types, predictors and outcomes, and be restricted to high threat to life injuries. We sought to identify the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare in determining short-term functional outcomes for a wide range of injuries. METHODS: Study participants (aged 18-64 years inclusive) were those in the Prospective Outcomes of Injury Study, a cohort of 2856 persons who were injured and registered with New Zealand's national no-fault injury insurance agency. All information used in this paper was obtained directly from the participants, primarily by telephone interviews, approximately three months after their injury. The functional outcomes of interest were the five dimensions of the EQ-5D plus a cognitive dimension. We initially examined bivariate relationships between our independent measures and the dependent measures. Our multivariate analyses included adjustment for pre-injury EQ-5D status and time between injury and when information was obtained from participants. RESULTS: Substantial portions of participants continued to have adverse outcomes approximately three months after their injury. Key pervasive factors predicting adverse outcomes were: being female, prior chronic illness, injuries to multiple body regions, being hospitalized for injury, self-perceived threat to life, and difficulty accessing health services. CONCLUSION: Future injury outcome studies should include participants whose injuries are considered 'minor', as judged by acute health service utilization, and also consider a wider range of potential predictors of adverse outcomes.