Pre-injury Health Research Articles

Pre-injury health status of injured patients: a prospective comparison with the Dutch population

PurposeThe aim of this study was to assess whether injured patients have a different pre-injury health status compared to the Dutch population.MethodsA broad range of injured patients (age ≥ 18 and ≤ 75 years) completed the condition-specific Short Musculoskeletal Function Assessment (SMFA-NL) and generic health-related quality of life questionnaire EuroQol-5D (EQ-5D), within 2 weeks after patients sustained an injury. Patients reported their health status of the week before their injury. Scores were compared to the Dutch normative data of the questionnaires. Gender, age, educational level, relationship status, and comorbidity adjusted differences were calculated for the SMFA-NL.ResultsA total of 596 injured patients completed the questionnaires (response rate: 43%). Unadjusted pre-injury SMFA-NL scores of injured patients were significantly better compared to the Dutch normative data (ranging from + 2.4 to + 8.6 points, p < 0.001 for all subscales and indices). The unadjusted EQ-5D difference score was 0.05 points (p < 0.001) higher in the group of injured patients. Adjusted pre-injury scores were higher than the SMFA-NL normative data. Function index: + 3.6, p < 0.001, bother index: + 3.0, p < 0.001 upper extremity dysfunction: + 0.8, p = 0.2, lower extremity dysfunction: + 3.7, p < 0.001. Problems with daily activities: + 2.8, p = 0.001. Mental and emotional problems: + 6.8, p < 0.001.ConclusionsInjured patients reported a better pre-injury health status compared to the Dutch population. Patient characteristics explained an important part of the difference in health status between injured patients and the Dutch population.

Pre-injury Mental Health Predictors of Depression and Suicidality: Five-Year Follow-Up Data from the TBI Model Systems

Pre-injury Mental Health Predictors of Depression and Suicidality: Five-Year Follow-Up Data from the TBI Model Systems

Exploring Multivariate Predictors of Return to School and Sports Following Concussion in High School Athletes

To examine whether demographic and pre-injury health conditions are related to functional recovery following sport-related concussion among high school athletes.

Exploring Multivariate Models to Predict Return to School and Sports Following Concussion in Collegiate Athletes

To examine if and how demographic factors and pre-injury health histories are related to functional recovery from a sport-related concussion among collegiate athletes using a multivariate framework.

Examining age-related differences in functional domain impairment following traumatic brain injury.

To examine differences in the functional recovery trajectories between younger and older adults with mild-moderate traumatic brain injury (TBI) in the first year postinjury as well as health-related quality of life. Observational cohort. Level one trauma centre in the State of Washington. Adults with mild-moderate TBI (N=34; younger adults, n=19, and older adults, n=15). None. Functional Status Examination (FSE) and health-related quality of life (HRQOL; SF-12v2). Older adults consistently showed significantly worse functional performance than younger adults following TBI in the following FSE domains: mobility, ability to travel, home maintenance and overall functional status. For both groups, preinjury physical health was significantly correlated with ability to travel and social integration at 12-month postinjury. Older participants' preinjury physical and mental health had significant and negative correlation with their functional status. Our study provides insights and implications into adults' specific functional impairments following TBI, and which domains have persistent deficits. Early intervention and rehabilitation should focus on improving older adults' physical functioning and mobility. Our study may also inform future research and design of post-TBI interventions for older adults.

Postrehabilitation Mental Health Treatment Utilization in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study.

To identify preinjury variables related to mental health treatment utilization at 2 years post-traumatic brain injury (TBI). Veterans Affairs (VA) TBI Model Systems includes 5 VA Polytrauma Rehabilitation Centers. Veterans and service members enrolled in TBI Model Systems who completed the year 2 follow-up assessment and provided mental health information. Sample was largely male (97%) and White (72%), with median age of 30 years. Participants with elevated mental health symptoms were identified by measures of depression, anxiety, and posttraumatic distress; suicide attempt in the past year; or problematic substance use in the past year. Forty-seven percent of participants had elevated mental health symptoms at 2 years postinjury. Among those with elevated symptoms, comparisons were made between those who sought mental health treatment in past year and those who did not. Demographic, historic, environmental, psychological/mental health, and injury/rehabilitation variables. Within the sample, 23% denied utilizing mental health services. Nonutilizers were more likely to deny a preinjury mental health treatment history, to report problematic substance use at year 2, and to report lower levels of internalizing symptoms than the treatment utilizers. Veterans and service members with elevated mental health symptoms may require tailored tactics to promote treatment utilization post-TBI.

A systematic review of lost-time injuries in the global mining industry.

Mining is a hazardous occupation with elevated rates of lost-time injury and disability. The purpose of this study is twofold: 1) To identify the type of lost-time injuries in the mining workforce, regardless of the kind of mining and 2) To examine the antecedent factors to the occupational injury (lost-time injuries). We identified and extracted primary papers related to lost-time injuries in the mining sector by conducting a systematic search of the electronic literature in the eight health and related databases. We critically reviewed nine articles in the mining sector that examined lost-time injuries. Musculoskeletal injuries (hand, back, limbs, fractures, lacerations and muscle contusions), slips and falls were identified as types of lost-time injuries. The review identified the following antecedent factors related to lost-time injuries: the mining work environment (underground mining), being male, age, working with mining equipment, organizational size, falling objects, disease status, job training and lack of occupational safety management teams, recovery time, social supports, access to health services, pre-injury health status and susceptibility to injury. The mining sector is a hazardous environment that increases workers' susceptibility to occupational injuries. There is a need to create and implement monitoring systems of lost-time injuries to implement prevention programs.

Prevalence and predictors of tobacco smoking in veterans and service members following traumatic brain injury rehabilitation: a VA TBIMS study

ABSTRACTObjective: To identify prevalence and predictors of tobacco smoking among veterans and military service members (V/SM) with traumatic brain injury (TBI) admitted for rehabilitation.Methods: Participants were drawn from the VA TBI Model Systems multicentre longitudinal research study. Tobacco smoking was assessed both preinjury and at 1- or 2-year post-TBI follow-up for 336 participants.Results: Smoking prevalence was 32% preinjury and 28% at follow-up. Most participants had a stable smoking pattern but 12% of preinjury non-smokers became smokers at follow-up. Preinjury smoking was the strongest predictor of post-TBI smoking. Higher cognitive function also predicted smoking at follow-up. In univariate analyses, smoking was predicted by lower education, preinjury mental health (MH) history, selected TBI severity metrics, and higher functional status at rehabilitation hospital discharge (Disability Rating Scale [DRS] and motor subscale of the Functional Independence Measure [FIM]).Conclusion: Study findings may help clinicians and administrators recognize who is at high risk for smoking following TBI, to plan for in-hospital and postdischarge screening and interventions.

Chapter 16 - Neuropsychiatry of sport-related concussion

Changes in mood, emotions, and behavior are common components of the acute clinical picture of sport-related concussion (SRC). Common concussion symptom inventories such as the Sport Concussion Assessment Tool-5 (SCAT5) contain a large number of questions that assess these neuropsychiatric domains. In fact, of 22 items assessed by the SCAT5, arguably only five of the items do not overlap with symptoms assessed by standard measures of anxiety and depression, suggesting that concussion is best viewed as a neuropsychiatric syndrome. Furthermore, it is important to understand the complex relationship between preinjury psychologic health, acute injury symptom profile, and the role that changes in mood, emotions, and behavior play in the recovery trajectory after concussion. Some research suggests that there may also be long-term neuropsychiatric effects of concussion, repetitive concussion, and repetitive head impacts. This chapter provides a review of the neuropsychiatric sequelae of acute SRC, the current evidence for long-term neuropsychiatric effects of repetitive concussion, and the impact of neuropsychiatric symptoms on recovery trajectory. Clinical principles relevant to management are described.

Geriatric Traumatic Brain Injury: Epidemiology, Outcomes, Knowledge Gaps, and Future Directions.

This review of the literature on traumatic brain injury (TBI) in older adults focuses on incident TBI sustained in older adulthood ("geriatric TBI") rather than on the separate, but related, topic of older adults with a history of earlier-life TBI. We describe the epidemiology of geriatric TBI, the impact of comorbidities and pre-injury function on TBI risk and outcomes, diagnostic testing, management issues, outcomes, and critical directions for future research. The highest incidence of TBI-related emergency department visits, hospitalizations, and deaths occur in older adults. Higher morbidity and mortality rates among older versus younger individuals with TBI may contribute to an assumption of futility about aggressive management of geriatric TBI. However, many older adults with TBI respond well to aggressive management and rehabilitation, suggesting that chronological age and TBI severity alone are inadequate prognostic markers. Yet there are few geriatric-specific TBI guidelines to assist with complex management decisions, and TBI prognostic models do not perform optimally in this population. Major barriers in management of geriatric TBI include under-representation of older adults in TBI research, lack of systematic measurement of pre-injury health that may be a better predictor of outcome and response to treatment than age and TBI severity alone, and lack of geriatric-specific TBI common data elements (CDEs). This review highlights the urgent need to develop more age-inclusive TBI research protocols, geriatric TBI CDEs, geriatric TBI prognostic models, and evidence-based geriatric TBI consensus management guidelines aimed at improving short- and long-term outcomes for the large and growing geriatric TBI population.

Preinjury ASA score as an independent predictor of readmission after major traumatic injury

BackgroundPatients with trauma have a high predisposition for readmission after discharge. Unplanned solicitation of medical services is a validated quality of care indicator and is associated with considerable economic costs....

Return to Play and Outcomes in Baseball Players After Superior Labral Anterior-Posterior Repairs

Background: Few studies have documented the outcomes of superior labral anterior-posterior (SLAP) repairs in baseball players. Furthermore, the results of these previous studies varied widely and were based on small numbers of patients. Hypothesis/Purpose: The purpose was to report return-to-play (RTP) rates and validated subjective outcome scores for baseball players after SLAP repair. It was hypothesized that RTP rates and outcomes would be significantly different between pitchers and nonpitchers, as well as among baseball levels. Study Design: Case series; Level of evidence, 4. Methods: A series of 216 baseball players was identified who had isolated SLAP repair or SLAP repair with debridement of partial-thickness (<25%) rotator cuff tear at our surgical centers. Patients were contacted by phone a minimum of 2 years after surgery and asked questions about their ability to RTP. Patients were also asked questions to complete the Western Ontario Shoulder Instability Index (WOSI), Veteran’s RAND 12-Item Health Survey (VR-12), and Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaires. Statistical equivalence in RTP rate, VR-12, and WOSI scores was determined between players with and without concomitant rotator cuff debridement using 2 one-sided tests and risk difference measures. Differences in RTP were tested among baseball levels (high school, college, professional) and positions (pitcher vs nonpitcher) using chi-square analyses (P < .05). Differences in outcomes scores were compared using t tests and analyses of variance (P < .05). Results: Of the 216 baseball players, 133 were reached by phone for follow-up interview (mean, 78 months; range, 27-146 months). Overall, 62% successfully returned to play. There were no differences in RTP rates or subjective outcomes among baseball levels or between procedures. RTP rates were 59% for pitchers and 76% for nonpitchers (P = .060). Subjectively, the percentage of patients who felt the same or better at follow-up compared to preinjury was significantly higher among nonpitchers (66%) than pitchers (43%). There was no difference in KJOC scores between the pitchers (75.3 ± 19.4) and nonpitchers (76.2 ± 17.4) who successfully returned to play, although these scores were well below the minimum desired score of 90 for healthy baseball players. Conclusion: SLAP repair should continue to be considered as an option for SLAP tear treatment only after nonsurgical management has failed. Some players may be able to return to baseball after SLAP repair, although regaining preinjury health and performance is challenging.

B-72Predicting Acute Post-Concussion Symptoms and Cognition from Pre-Injury Mental Health Treatment

B-72Predicting Acute Post-Concussion Symptoms and Cognition from Pre-Injury Mental Health Treatment

General Health Status After Nonoperative Versus Operative Treatment for Acute, Complete Acromioclavicular Joint Dislocation: Results of a Multicenter Randomized Clinical Trial

To assess the general health status of patients after nonoperative (Non-op) versus operative (OP) treatment for acromioclavicular (AC) joint dislocations. Multicenter randomized controlled clinical trial conducted in 11 Canadian trauma centers. A total of 83 patients with acute (≤28 days old), complete (Rockwood grades III, IV, or V) dislocations of the AC joint were included in this study. Participants were randomized to Non-op treatment or OP treatment with hook plate fixation. Physical and mental health were evaluated using the Short Form-36 version 2 survey at baseline, 6 weeks, 3 months, 6 months, 1 year, and 2 years. In the Non-op group, 33 patients had grade III injuries, 3 patients had grade IV injuries, 5 patients had grade V injuries, and the injury grade was unknown for 2 patients. In the OP group, 37 patients had grade III injuries and 3 patients had grade V injuries (no difference in Type IV and V Non-op vs. OP, P = 0.12). Fifty-eight percent of patients in the Non-op group and 63% of patients in the OP group completed the 2-year follow-up. The Non-op group had better physical health scores than the OP group at 3 months after treatment (52.13 vs. 45.75, P < 0.001). There were no significant differences between the physical health scores of the 2 groups at any other point (6 weeks, 45.81 vs. 41.21, P = 0.03; 6 months, 54.50 vs. 51.61, P = 0.02; 1 year, 55.10 vs. 53.96, P = 0.37; 2 years, 55.24 vs. 57.13, P = 0.17). Mental health scores were similar between the Non-op and OP groups at each follow-up interval (6 weeks, 49.29 vs. 51.27, P = 0.49; 3 months, 52.24 vs. 55.84, P = 0.13; 6 months, 54.89 vs. 55.05, P = 0.93; 1 year, 55.35 vs. 56.72, P = 0.35; 2 years, 56.41 vs. 55.43, P = 0.56). In both treatment groups, the preinjury physical and mental health scores were better than published population norms before declining to a level equal to or below the norm after dislocation. Physical health recovered to a level above the norm at 6 months in the Non-op group and 2 years in the OP group. Mental health recovered at 3 months in the OP group and 6 months in the Non-op group. Hook plate fixation does not lead to improved general health status compared with Non-op treatment. Presently, there is no definitive evidence that hook plate fixation is superior to Non-op treatment for acute complete AC joint dislocations. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Predictors of Satisfaction With Life in Veterans After Traumatic Brain Injury: A VA TBI Model Systems Study.

To identify predictors of satisfaction with life in Veterans 1 year after traumatic brain injury (TBI). The VA TBI Model Systems (TBIMS) project includes 5 Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Veterans enrolled in the VA TBIMS study who completed the Satisfaction With Life Scale at year 1 follow-up. The sample is largely male (96%) and Caucasian (72%), with a median age of 27 years upon enrollment. Prospective observational cohort study measuring including demographics (eg, education), preinjury variables (eg, mental health history and employment), and military variables (eg, injury during deployment and injury during active duty status). Satisfaction With Life Scale. Multivariate regression analyses revealed that age, marital status, preinjury employment status, preinjury mental health history, and active duty status at the time of injury were significant predictors of life satisfaction at year 1 follow-up. Results of this study suggest that satisfaction with life in Veterans with TBI is mediated by several factors that might inform rehabilitation interventions and discharge recommendations. Preinjury variables and active duty status (a unique aspect of the Veteran population) influence life satisfaction at 1 year postinjury. Limitations and future clinical implications will be discussed.

Early predictors of outcome after mild traumatic brain injury (UPFRONT): an observational cohort study

Mild traumatic brain injury (mTBI) accounts for most cases of TBI, and many patients show incomplete long-term functional recovery. We aimed to create a prognostic model for functional outcome by combining demographics, injury severity, and psychological factors to identify patients at risk for incomplete recovery at 6 months. In particular, we investigated additional indicators of emotional distress and coping style at 2 weeks above early predictors measured at the emergency department. The UPFRONT study was an observational cohort study done at the emergency departments of three level-1 trauma centres in the Netherlands, which included patients with mTBI, defined by a Glasgow Coma Scale score of 13-15 and either post-traumatic amnesia lasting less than 24 h or loss of consciousness for less than 30 min. Emergency department predictors were measured either on admission with mTBI-comprising injury severity (GCS score, post-traumatic amnesia, and CT abnormalities), demographics (age, gender, educational level, pre-injury mental health, and previous brain injury), and physical conditions (alcohol use on the day of injury, neck pain, headache, nausea, dizziness)-or at 2 weeks, when we obtained data on mood (Hospital Anxiety and Depression Scale), emotional distress (Impact of Event Scale), coping (Utrecht Coping List), and post-traumatic complaints. The functional outcome was recovery, assessed at 6 months after injury with the Glasgow Outcome Scale Extended (GOSE). We dichotomised recovery into complete (GOSE=8) and incomplete (GOSE≤7) recovery. We used logistic regression analyses to assess the predictive value of patient information collected at the time of admission to an emergency department (eg, demographics, injury severity) alone, and combined with predictors of outcome collected at 2 weeks after injury (eg, emotional distress and coping). Between Jan 25, 2013, and Jan 6, 2015, data from 910 patients with mTBI were collected 2 weeks after injury; the final date for 6-month follow-up was July 6, 2015. Of these patients, 764 (84%) had post-traumatic complaints and 414 (45%) showed emotional distress. At 6 months after injury, outcome data were available for 671 patients; complete recovery (GOSE=8) was observed in 373 (56%) patients and incomplete recovery (GOSE ≤7) in 298 (44%) patients. Logistic regression analyses identified several predictors for 6-month outcome, including education and age, with a clear surplus value of indicators of emotional distress and coping obtained at 2 weeks (area under the curve [AUC]=0·79, optimism 0·02; Nagelkerke R2=0·32, optimism 0·05) than only emergency department predictors at the time of admission (AUC=0·72, optimism 0·03; Nagelkerke R2=0·19, optimism 0·05). Psychological factors (ie, emotional distress and maladaptive coping experienced early after injury) in combination with pre-injury mental health problems, education, and age are important predictors for recovery at 6 months following mTBI. These findings provide targets for early interventions to improve outcome in a subgroup of patients at risk of incomplete recovery from mTBI, and warrant validation. Dutch Brain Foundation.

Identification of patients at risk for poor outcome after mTBI

The study by Joukje van der Naalt and colleagues 1 van der Naalt J Timmermans ME de Koning ME et al. Early predictors of outcome after mild traumatic brain injury (UPFRONT): an observational cohort study. Lancet Neurol. 2017; 16: 532-540 Summary Full Text Full Text PDF PubMed Scopus (179) Google Scholar in The Lancet Neurology aimed to develop a prognostic model for 6-month functional outcome in 679 patients with mild traumatic brain injury (mTBI). In their model, the authors used a multifactorial approach by including sociodemographic, injury-related, and pre-injury factors, as well as indicators of stress after injury and coping strategies. Of the factors measured on admission to the emergency department, lower education, female sex, mental health problems before injury, neck pain, lower Glasgow Coma Scale scores, shorter post-traumatic amnesia, and the absence of alcohol intoxication were found to be associated with incomplete recovery at 6 months. Of factors measured 2 weeks after injury, depression, anxiety, post-traumatic complaints, and passive and avoidant coping styles were also associated with worse 6-month outcome. These were combined in two prognostic models to predict 6-month functional outcome: one applicable using only information recorded on admission to the emergency department, and one using admission information and data collected at 2 weeks after injury. Early predictors of outcome after mild traumatic brain injury (UPFRONT): an observational cohort studyPsychological factors (ie, emotional distress and maladaptive coping experienced early after injury) in combination with pre-injury mental health problems, education, and age are important predictors for recovery at 6 months following mTBI. These findings provide targets for early interventions to improve outcome in a subgroup of patients at risk of incomplete recovery from mTBI, and warrant validation. Full-Text PDF

Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries

BackgroundCompensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma. The study was conducted in New South Wales (NSW), Australia, in motor vehicle crash and workers’ compensation schemes.MethodsParticipants were patients admitted with upper or lower extremity factures following a motor vehicle crash to two trauma hospitals. Data were collected at baseline within two weeks of injury. Participants were followed up at six months. Analysis involved: descriptive statistics for baseline characteristics; comparison of compensable and non-compensable participants with Analysis of Variance (ANOVA) and chi-squared tests; and logistic regression for predictor models.ResultsThe cohort consisted of 452 participants with a mean age 40 years; 75% male; 74% working pre-injury; 30% in excellent pre-injury health; 56% sustained serious injuries with an Injury Severity Score (ISS) 9-15; 61% had a low-middle range household income; and 35% self-reported at fault in the crash. There was no significant difference in pre-injury/baseline health between compensable and non-compensable participants. Follow up data was available for 301 (67%) participants.The significant predictor of claiming compensation in the adjusted analysis was higher body mass index (BMI) (overweight Odds Ratio [OR] 3.05, 95% Confidence Interval [CI] 1.63-5.68; obese OR 1.63, 95% CI 0.83-3.20). Participants less likely to claim were: involved in a motorcycle crash (OR 0.47, 95% CI 0.28-0.82); socioeconomically less disadvantaged (OR 0.37, 95% CI 0.17-0.82) or least disadvantaged (OR 0.39, 95% CI 0.17-0.90); at risk for short term harm (injury) due to alcohol consumption (OR 0.56, 95% CI 0.32-0.97); and with fair-poor pre-injury health (OR 0.30, 95% CI 0.09-0.94). The predictors for seeking legal representation were speaking a language other than English at home (OR 2.80, 95% CI 1.2-6.52) and lower household income (OR 3.63, 95% CI 1.22-10.72). Participants less likely to seek legal representation were least socioeconomically disadvantaged (OR 0.15, 95% CI 0.04-0.50).ConclusionsSeeking financial compensation was associated with a higher pre-injury BMI rather than injury-related factors. Seeking legal representation was solely related to socio-economic factors.

Patterns of health care use of injured adults: A population-based matched cohort study

BackgroundHealthcare use by traumatically injured individuals prior to and subsequent to their injury are not often explored for different types of injuries. This study aims to describe health care use 12 months preceding and 12 months following a traumatic injury by injury type and injury severity. MethodHospital and mortality data from three Australian states were linked in a population-based matched cohort study. Individuals ≥18 years who had an injury-related hospital admission in 2009 were identified as the injured cohort. A comparison cohort of non-injured people, matched 1:1 on age, gender and postcode of residence, was randomly selected from the electoral roll. Twelve-month pre- and post-index injury health service use was examined. Rates, adjusted rate ratios and attributable risk proportions were calculated by injury type and severity. ResultsThe injury cohort experienced higher 12-month pre- and post-injury hospital admissions than the non-injured group. By 6 to 7 months post-injury, the injury cohort had largely returned to their pre-injury health service use levels, except for injuries involving dislocations, sprains and strains and injury to nerves and spinal cord. Hip fracture (17.69 per 100 person-months) and poisoning (16.09 per 100 person-months) had the highest rates of post-injury hospitalisation in the injured cohort. The adjusted rate ratios (ARR) for post-injury hospitalisation were highest for poisoning (ARR: 3.77; 95% CI: 3.38–4.21) and injury to nerves and spinal cord (ARR: 2.73; 95% CI: 2.27–3.28). Poisoning also had the highest ARR for post-injury LOS (ARR: 5.31; 95% CI: 4.51–6.27). ConclusionsAfter sustaining a traumatic injury, many individuals are readmitted to hospital and require ongoing care up to 12 months post-injury. That injured individuals post-injury largely return to their pre-index injury hospital use by 6 to 7 months could imply a return to pre-injury function and/or that other measures of health service use should be explored. Trauma services should consider long-term follow-up and support services for seriously injured patients post-hospital discharge.

Health-related quality of life 24 months after sustaining a minor musculoskeletal injury in a road traffic crash: A prospective cohort study

ABSTRACTObjectives: A better understanding of the long-term factors that independently predict poorer quality of life following mild to moderate musculoskeletal injuries is needed. We aimed to establish the predictors of quality of life (including sociodemographic, health, psychosocial, and pre-injury factors) 24 months after a noncatastrophic road traffic injury.Methods: In a prospective cohort study of 252 participants with mild/moderate injury sustained in a road traffic crash, quality of life was measured 24 months following the baseline survey. A telephone-administered questionnaire obtained information on various potential explanatory variables. Health-related quality of life was measured using the European Quality of Life–5 Dimensions (EQ-5D) and Medical Outcomes Survey Short Form–12 (SF-12). Multivariable linear regression analyses determined the associations between explanatory variables and quality of life measures.Results: Mean SF-12 physical component summary (PCS) and mental component summary (MCS) scores increased by 7.3 and 2.5 units, respectively, from baseline to 24-month follow-up. Each 10-year increase in baseline age was independently associated with 3.1-unit (P < .001) and 1.5-unit (P = .001) decrease in EQ Visual Analogue Scale (VAS) and SF-12 PCS scores at follow-up, respectively. Poor/fair compared to excellent pre-injury health was associated with a 0.16-, 21.3-, and 11.5-unit decrease in EQ-5D summary (P = .03), VAS scores (P = .001), and SF-12 PCS scores (P < .001), respectively. Baseline pain severity ratings and pain catastrophizing scores were inversely associated with 24-month EQ VAS scores (both P < .001). Each unit increase in baseline pain score (P = .001) and pain catastrophizing score (P = .02) was associated with a 1.0- and 4.6-unit decrease in SF-12 MCS scores at 24 months, respectively. Other observed predictors of quality of life measures (EQ-5D summary and/or VAS scores and/ or SF-12 MCS) included marital status, smoking, hospital admission, pre-injury health (anxiety/depression and chronic illness), and whiplash injury.Conclusion: Sociodemographic indicators, pre-injury health, and biopsychosocial correlates were independently associated with health-related quality of life 24 months following a noncatastrophic road traffic crash injury.