Prevalence and predictors of disability 24-months after injury for hospitalised and non-hospitalised participants: results from a longitudinal cohort study in New Zealand

• Published in: PloS one 2013-11, Vol.8 (11), p.e80194-e80194
• Main Authors: Derrett, Sarah, Wilson, Suzanne, Samaranayaka, Ari, Langley, John, Wyeth, Emma, Ameratunga, Shanthi, Lilley, Rebbecca, Davie, Gabrielle, Mauiliu, Melbourne
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis; Body mass; Chronic conditions; Cohort analysis; Cohort Studies; Compensation; Consent; Demographics; Disability; Disabled Persons - statistics & numerical data; Employment; Female; Health care; Health care industry; Health risks; Health sciences; Hospitalization; Hospitals; Humans; Injuries; Injury prevention; Insurance Claim Review; Longitudinal Studies; Male; Medicine; Middle Aged; New Zealand - epidemiology; Poisson density functions; Population; Prevalence; Quality of life; Regression analysis; Risk assessment; Sex crimes; Statistical analysis; Studies; Trauma; Wounds and Injuries - epidemiology; Wounds and Injuries - physiopathology; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0080194

Most studies investigating disability outcomes following injury have examined hospitalised patients. It is not known whether variables associated with disability outcomes are similar for injured people who are not hospitalised. This paper compares the prevalence of disability 24 months after injury for participants in the Prospective Outcomes of Injury Study who were hospitalised and those non-hospitalised, and also seeks to identify pre-injury and injury-related predictors of disability among hospitalised and non-hospitalised participants. Participants, aged 18-64 years, were recruited from an injury claims register managed by New Zealand's no-fault injury compensation insurer after referral by health care professionals. A wide range of pre-injury socio-demographic, health and psychosocial characteristics were collected, as well as injury-related characteristics; outcome is assessed using the WHODAS. Multivariable models estimating relative risks of disability for hospitalised and non-hospitalised participants were developed using Poisson regression methods. Of 2856 participants, analyses were restricted to 2184 (76%) participants for whom both pre-injury and 24 month WHODAS data were available. Of these, 25% were hospitalised. In both hospitalised and non-hospitalised groups, 13% experience disability (WHODAS≥10) 24 months after injury; higher than pre-injury (5%). Of 28 predictor variables, seven independently placed injured participants in the hospitalised group at increased risk of disability 24 months after injury; eight in the non-hospitalised. Only four predictors (pre-injury disability, two or more pre-injury chronic conditions, pre-injury BMI≥30 and trouble accessing healthcare services) were common to both the hospitalised and non-hospitalised groups. There is some evidence to suggest that among the hospitalised group, Māori have higher risk of disability relative to non-Māori. At 24 months considerable disability is borne, equally, by hospitalised and non-hospitalised groups. However, predictors of disability are not necessarily consistent between the hospitalised and non-hospitalised groups, suggesting caution in generalising results from one group to the other.