Pre-injury health status of major trauma patients with orthopaedic injuries. Issue 2 (February 2020)

• Record Type: Journal Article
• Authors: Gelaw, Asmare Yitayeh; Gabbe, Belinda J.; Simpson, Pamela M.; Ekegren, Christina L.
• Is Part Of: Injury. Volume 51:Issue 2(2020)
• Page Start: 243
• Page End: 251
• Publication Date: 2020-02
• Subjects: Pre-injury -- Orthopaedic -- Trauma -- Injury -- Health status -- Quality of life; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2019.12.016
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlight: Major trauma patients with orthopaedic injuries reported better pre-injury health status compared to the Australian population. Values of pre-injury health status reported 6, 12 and 24 months post-injury are comparable There exists a significant association between pre-injury health status and patient age, comorbidities, injury related factors, socioeconomic status and work related factors People with orthopaedic trauma are either healthier than the general population before injury, or have an inflated impression of their pre-injury health. Abstract: Background: Pre-injury health status is an important determining factor of long-term outcomes after orthopaedic major trauma. Determining pre-injury health status of major trauma patients with orthopaedic injuries is also important for evaluating the change from pre to post-injury health status. Objectives: Describe pre-injury health statuses reported at three different time points (6, 12 and 24 months) after injury and compare these with Australian normative values; determine the agreement between pre-injury health status collected at multiple time points post-injury; and identify factors associated with reporting better pre-injury health status. Materials and Methods: A registry-based cohort study was conducted. Major trauma patients with orthopaedic injuries captured by the Victorian State Trauma Registry with a date of injury from January 2009 to December 2016 were included. Pre-injury health status (measured using the EuroQol-Visual Analogue Scale (EQ-VAS)), reported 6, 12 and 24 months post-injury, was compared against Australian population normative values. The Bland-Altman method of comparison was used to determine the agreement between pre-injury EQ-VAS scores reported 6 to 12 and 6 to 24 months post-injury. Mixed effects ordinal logistic regression was used to determine factors associated with reporting better pre-injury health status. Results: A total of 3, 371 patients were eligible for the study. The median (IQR) pre-injury EQ-VAS score reported 6, 12 and 24 months post-injury was 90 (85–100) out of 100. Participants' pre-injury EQ-VAS scores reported 6, 12 and 24 months post-injury were significantly higher than Australian population normative values. Pre-injury EQ-VAS scores reported 6 months post-injury agreed with pre-injury EQ-VAS scores reported 12 and 24 months post-injury. A significant association exists between pre-injury health status and age, comorbidities, injury characteristics, socioeconomic status and pre-injury work status. Conclusions: People with orthopaedic major trauma have better pre-injury health compared to the general Australian population. Therefore, population-specific values should be used as baseline measures to evaluate orthopaedic trauma outcomes. Pre-injury health status values reported at three different post-injury time points were comparable. If conducting a retrospective pre-injury health evaluation, researchers need be aware of factors that influence self-reporting of pre-injury health status and the response shift that may happen due to encountering injury.