Injury characteristics and EQ-5D as predictors of personal wellbeing after injury

Abstract

Objectives: A longitudinal study examined the relationships of injury severity, whether the injury was accidental or was caused by an assault, and self-reported EQ-5D soon after injury, with long-term personal wellbeing among participants with a range of injury types and severity. Methods: Interviews with participants recruited in the Prospective Outcomes of Injury Study (POIS) were conducted up to four time points in the 24 months after injury. Key explanatory variables were New Injury Severity Score (NISS), whether the injury was accidental or resulted from assault, and self-reported health status (five EQ-5D questions and a similar question about cognition) reported at three months. The main outcome measure at 24 months was the Personal Wellbeing Index (PWI) (PWI <70=‘low’ wellbeing). Univariate and multivariable analyses examined relationships between explanatory variables and low PWI. Results: Even in a group of people with injuries traditionally regarded as being of mild or moderate anatomical severity, wellbeing continues to be affected for an appreciable time post-injury, with a quarter (27%) of study participants having a low level of personal wellbeing 24 months after their injury. Neither anatomical injury severity nor hospitalisation were predictive of low personal wellbeing. An increased risk of low personal wellbeing was observed in participants whose injury was caused by an intentional assault (rather than accident), and in those who reported problems three months post-injury with EQ-5D self-care, anxiety/depression or cognitive functioning. Conclusions: Identification of such individuals early after an injury is of particular importance and ensuring adequate support services are put in place that encourage re-integration back into work and social networks could help prevent on-going poor wellbeing.