2134/23047
Denise Kendrick
Denise
Kendrick
Blerina Kellezi
Blerina
Kellezi
Carol Coupland
Carol
Coupland
A. Maula
A.
Maula
Kate Beckett
Kate
Beckett
Richard Morriss
Richard
Morriss
Stephen Joseph
Stephen
Joseph
Jo Barnes
Jo
Barnes
Jude Sleney
Jude
Sleney
Nicola Christie
Nicola
Christie
Psychological morbidity and health related quality of life after injury: multicentre cohort study
Loughborough University
2016
Unintentional injury
Quality of life
Depression
Anxiety
Cohort study
Design Practice and Management not elsewhere classified
2016-11-03 14:00:11
Journal contribution
https://repository.lboro.ac.uk/articles/journal_contribution/Psychological_morbidity_and_health_related_quality_of_life_after_injury_multicentre_cohort_study/9346637
Purpose To demonstrate the impact of psychological morbidity 1 month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in
the UK to inform development of trauma care and rehabilitation services.
Methods Multicentre cohort study of 16–70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at
recruitment and 1, 2, 4 and 12 months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity
1 month post-injury and MID in HRQoL over the
12 months after injury.
Results A total of 668 adults participated. Follow-up rates were 77% (1 month) and 63% (12 months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1 month and 58% at 12 months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1 month post-injury were independently associated with subsequent
MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship
between anxiety and HRQoL was not explained by factors measured in our study.
Conclusions Hospitalised injuries result in substantial reductions in HRQoL up to 12 months later. Depression and anxiety early in the recovery period are independently
associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving
HRQoL post-injury.