The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Asmare Yitayeh Gelaw, Belinda J. Gabbe, Sarah J. Arnup, Sandra Reeder, Mark Fitzgerald, Ronan Anthony Lyons, Jennie Louise Ponsford, Alex Collie, Nicola Christie, Andrew Nunn, James E. Harrison, Peter Cameron, Christina L. Ekegren

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Abstract

Background: A better understanding of how chronic physical health conditions affect long-term outcomes following injury is essential for quantifying the burden of serious orthopaedic injuries. We aimed to describe the association between the presence of post-injury chronic physical health conditions and (i) the change in health status from before injury to six different follow-up time points after injury; and (ii) survival time. 

Methods: A cohort study was conducted using linked data from the REcovery after Serious Trauma: Outcomes, Resource Use, and Patient Experiences study, the Victorian Registry of Births, Deaths and Marriages (BDM) (2009–2017), the victorian admitted episodes dataset (2009–2017) and the victorian emergency minimum dataset (2009–2017). Adults (≥ 18 years old) with serious orthopaedic injuries who survived to discharge from their trauma admission were included. Multivariable linear regression analysis was conducted to evaluate the association between post-injury chronic physical health conditions and the mean change in health status (EuroQol-Visual Analogue Scale) from before injury to six follow-up time points post-injury. Survival analysis was conducted to estimate the probability of survival for people with and without chronic physical health conditions following injury. 

Results: Out of 894 participants, 177 (19.8%) had at least one chronic physical health condition recorded up to five years post-injury. People with post-injury conditions reported a greater mean decline in health status than people without post-injury conditions (difference, (95% CI): −6.9 (−9.7, −4.2), p = 0.01). Over the study period, almost six times as many people with chronic physical health conditions post-injury died as people without these conditions (AHR (95% CI): 5.7 (2.9, 11.3), p < 0.01). 

Conclusions: Chronic physical conditions after serious orthopaedic injuries were associated with a lower survival probability and a deteriorating health status. Orthopaedic injury survivors may benefit from early detection and treatment of chronic conditions.

Original languageEnglish
Pages (from-to)39-50
Number of pages12
JournalTrauma (United Kingdom)
Volume27
Issue number1
Early online date23 Jan 2024
DOIs
Publication statusPublished - Jan 2025

Keywords

  • chronic conditions
  • chronic diseases
  • long-term outcomes
  • mortality
  • orthopaedic
  • Trauma

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