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Psychological morbidity and health related quality of life after injury: multicentre cohort study

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posted on 03.11.2016, 14:00 authored by Denise Kendrick, Blerina Kellezi, Carol Coupland, A. Maula, Kate Beckett, Richard Morriss, Stephen Joseph, Jo BarnesJo Barnes, Jude Sleney, Nicola Christie
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.

Funding

The project was funded by the National Institute for Health Research funding scheme for the Collaboration for Leadership in Applied Health Research and Care Nottinghamshire, Derbyshire and Lincolnshire, and now East Midlands.

History

School

  • Design and Creative Arts

Department

  • Design

Published in

Quality of Life Research

Volume

26

Pages

1233-1250

Citation

KENDRICK, D. ... et al, 2016. Psychological morbidity and health related quality of life after injury: multicentre cohort study. Quality of Life Research, 26 (5), pp. 1233–1250.

Publisher

© The Authors. Published by Springer Verlag (Germany)

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/ by/4.0/

Acceptance date

13/10/2016

Publication date

2016-10-26

Copyright date

2017

Notes

This is an Open Access Article. It is published by Springer under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/

ISSN

0962-9343

eISSN

1573-2649

Language

en