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ABSTRACT
Objectives: 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.
Acknowledgments
The authors' responsibilities were as follows—B.G., J.J., and I.D.C.: study concept and design; I.D.C.: acquisition of data; B.G., J.J., M.N., I.A.H., P.C., C.G.M., F.B., and I.D.C.: interpretation of data; B.G., J.J.: drafting of the article; B.G., J.J., M.N., I.A.H., P.C., C.G.M., F.B., and I.D.C.: critical revision of the article. All authors have given final approval of the version to be published.
Funding
The study is funded by the New South Wales State Insurance Regulatory Authority. The funder participates in the Steering Group for the study but has no direct involvement with the scientific aspects of the study. Professor Maher's and Professor Cameron's fellowship is funded by the Australian National Health and Medical Research Council.
Ethics approval
The study protocol was approved (including the verbal consent process) by the University of Sydney Human Research Ethics committee. All participants provided consent to participate in this study. This study was conducted according to the principles expressed in the Declaration of Helsinki.