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

<h4>Introduction</h4>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.<h4>Aims</h4>This paper comp...

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Autores principales: Sarah Derrett, Suzanne Wilson, Ari Samaranayaka, John Langley, Emma Wyeth, Shanthi Ameratunga, Rebbecca Lilley, Gabrielle Davie, Melbourne Mauiliu
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2013
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Acceso en línea:https://doaj.org/article/2e4c9f20e19847bdb9a9a86238bb17cb
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Sumario:<h4>Introduction</h4>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.<h4>Aims</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.