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Chronic physical health conditions following injury: a comparison of prevalence and risk in people with orthopaedic major trauma and other types of injury

  • Asmare Yitayeh Gelaw
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia

    Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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  • Belinda J. Gabbe
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia

    Health Data Research UK, Swansea University Medical School, Swansea University, UK
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  • Christina L. Ekegren
    Correspondence
    Corresponding author: Monash University Peninsula Campus, Frankston, VIC 3199; Tel: +61 3 9904 4847.
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia

    Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University

    Baker Heart and Diabetes Institute, Melbourne, Australia

    Alfred Emergency and Trauma Centre, Melbourne, Australia
    Search for articles by this author
Published:January 08, 2022DOI:https://doi.org/10.1016/j.apmr.2021.12.014

      Abstract

      Objective

      To determine: (i) the prevalence of chronic physical health conditions reported pre-injury, at the time of injury, up to one year post-injury and 1-5 years post-injury; and (ii) the risk of chronic physical health conditions reported 1-5 years post-injury in people with orthopaedic and other types of major trauma.

      Design

      Cohort study using linked trauma registry and health administrative datasets

      Setting

      This study used linked data from the Victorian State Trauma Registry (VSTR), the Victorian Registry of Births, Deaths and Marriages (BDM), the Victorian Admitted Episodes Dataset (VAED) and the Victorian Emergency Minimum Dataset (VEMD).

      Participants

      28,522 adult (18 years and over) major trauma patients, registered by the VSTR, with dates of injury from 2007 to 2016, who survived to at least one year post-injury, were included in this study. Major trauma cases were classified into four groups: i) orthopaedic injury, ii) severe traumatic brain injury (s-TBI), iii) spinal cord injury, and iv) other major trauma.

      Main Outcome Measure

      Prevalence of chronic physical health conditions

      Results

      The cumulative prevalence of any chronic physical health condition for all participants was 69.3%. The s-TBI group had the highest cumulative prevalence of conditions. The most common conditions were arthritis and arthropathies, cancer and cardiovascular diseases. Pre-injury chronic conditions were most common in people in people with severe TBI (19.3%), while they were least common in people with ‘other’ types of major trauma (6.6%). The highest prevalence of new-onset conditions following injury was found in people with severe TBI (21.7%) and orthopaedic major trauma (21.4%), while the lowest prevalence was found in people with ‘other’ types of major trauma (9.2%). For the orthopaedic injury group, there were no significant differences in the adjusted risk of conditions reported 1-5 years post-injury compared to other major trauma groups.

      Conclusion(s)

      Chronic physical health conditions were common among all injury groups. There was no significant difference in the risk of chronic conditions among injury groups. Rehabilitation practitioners should be aware of the risk of chronic conditions in people with orthopaedic and other types of major trauma. Long-term follow-up care following injury should include prevention and treatment of chronic conditions.

      Keywords

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      References

        • Curtis K
        • Caldwell E
        • Delprado A
        • Munroe B
        Traumatic injury in Australia and New Zealand.
        Australasian emergency nursing journal. 2012; 15: 45-54
        • Alberdi F
        • García I
        • Atutxa L
        • Zabarte M.
        Epidemiology of severe trauma.
        Medicina Intensiva (English Edition). 2014 Dec 1; 38: 580-588
        • Gabbe BJ
        • Sutherland AM
        • Hart MJ
        • Cameron PA.
        Population-Based Capture of Long-Term Functional and Quality of Life Outcomes After Major Trauma: The Experiences of the Victorian State Trauma Registry.
        Journal of Trauma and Acute Care Surgery. 2010 Sep; 69: 532
        • Dahm J
        • Ponsford J.
        Comparison of long-term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury?.
        Injury. 2015 Jan 1; 46: 142-149
        • Butcher JL
        • MacKenzie EJ
        • Cushing B
        • Jurkovich G
        • Morris J
        • Burgess A
        • et al.
        Long-term outcomes after lower extremity trauma.
        Journal of Trauma and Acute Care Surgery. 1996; 41: 4-9
        • Cross JD
        • Ficke JR
        • Hsu JR
        • Masini BD
        • Wenke JC.
        Battlefield Orthopaedic Injuries Cause the Majority of Long-term Disabilities.
        JAAOS - Journal of the American Academy of Orthopaedic Surgeons. 2011 Feb; 19: S1
        • Holtslag HR
        • van Beeck EF
        • Lindeman E
        • Leenen LP
        Determinants of long-term functional consequences after major trauma.
        Journal of Trauma and Acute Care Surgery. 2007; 62: 919-927
        • Stewart IJ
        • Sosnov JA
        • Howard JT
        • Orman JA
        • Fang R
        • Morrow BD
        • et al.
        Retrospective analysis of long term outcomes after combat injury: a hidden cost of war.
        Circulation. 2015; (CIRCULATIONAHA-115)
        • Howard JT
        • Sosnov JA
        • Janak JC
        • Gundlapalli AV
        • Pettey WB
        • Walker LE
        • et al.
        Associations of initial injury severity and posttraumatic stress disorder diagnoses with long-term hypertension risk after combat injury.
        Hypertension. 2018; 71: 824-832
        • Gelaw AY
        • Gabbe BJ
        • Braaf SC
        • McPhail S
        • Ekegren CL.
        Chronic physical health conditions and associated factors among people with serious orthopaedic injuries: A systematic review.
        Trauma. 2020 Nov 4; (1460408620968341)
        • Shively S
        • Scher AI
        • Perl DP
        Diaz-Arrastia R. Dementia Resulting From Traumatic Brain Injury.
        Arch Neurol. 2012 Oct; 69: 1245-1251
        • Jörgensen S
        • Iwarsson S
        • Lexell J.
        Secondary health conditions, activity limitations, and life satisfaction in older adults with long-term spinal cord injury.
        PM&R. 2017; 9: 356-366
        • Gardner RC
        • Burke JF
        • Nettiksimmons J
        • Goldman S
        • Tanner CM
        • Yaffe K.
        Traumatic brain injury in later life increases risk for Parkinson disease.
        Ann Neurol. 2015 Jun; 77: 987-995
        • Maiden MJ
        • Cameron PA
        • Rosenfeld JV
        • Cooper DJ
        • McLellan S
        • Gabbe BJ.
        Long-Term Outcomes after Severe Traumatic Brain Injury in Older Adults. A Registry-based Cohort Study.
        Am J Respir Crit Care Med. 2020; 201 (15): 167-177
        • Fischer MJ
        • Krishnamoorthi VR
        • Smith BM
        • Evans CT
        • Andre JRS
        • Ganesh S
        • et al.
        Prevalence of Chronic Kidney Disease in Patients with Spinal Cord Injuries/Disorders.
        AJN. 2012; 36: 542-548
        • Mendez MF.
        What is the Relationship of Traumatic Brain Injury to Dementia?.
        J Alzheimers Dis. 2017; 57: 667-681
        • Gardner RC
        • Burke JF
        • Nettiksimmons J
        • Kaup A
        • Barnes DE
        • Yaffe K.
        Dementia risk after brain versus non-brain trauma: the role of age and severity.
        JAMA Neurol. 2014 Dec; 71: 1490-1497
        • Köseoğlu BF
        • Safer VB
        • Öken Ö
        • Akselim S.
        Cardiovascular disease risk in people with spinal cord injury: is there a possible association between reduced lung function and increased risk of diabetes and hypertension?.
        Spinal Cord. 2017 Jan; 55: 87-93
        • Adriaansen JJE
        • Post MWM
        • de Groot S
        • van Asbeck FWA
        • Stolwijk-Swüste JM
        • Tepper M
        • et al.
        Secondary health conditions in persons with spinal cord injury: a longitudinal study from one to five years post-discharge.
        J Rehabil Med. 2013 Nov; 45: 1016-1022
        • Cragg JJ
        • Noonan VK
        • Krassioukov A
        • Borisoff J
        Cardiovascular disease and spinal cord injury.
        Neurology. 2013 Aug 20; 81: 723-728
        • Kuklina EV
        • Hagen EM.
        Link between cardiovascular disease and spinal cord injury.
        Neurology. 2013 Aug 20; 81: 700-701
        • Nordström A
        • Nordström P.
        Traumatic brain injury and the risk of dementia diagnosis: A nationwide cohort study.
        PLoS Med. 2018 Jan; 15e1002496
        • Cameron PA
        • Finch CF
        • Gabbe BJ
        • Collins LJ
        • Smith KL
        • McNeil JJ.
        Developing Australia's first statewide trauma registry: what are the lessons?.
        ANZ Journal of Surgery. 2004 Jun 1; 74: 424-428
      1. Department of Health & Human services D of H& H. Definition of major trauma [Internet]. Department of Health & Human Services; [cited 2021 Feb 19]. Available from: https://www2.health.vic.gov.au:443/hospitals-and-health-services/patient-care/acute-care/state-trauma-system/major-trauma-classification

        • Sundararajan V
        • Henderson TM
        • Ackland MJ
        • Marshall R.
        Linkage of the Victorian admitted episodes dataset. In: Symposium on health data linkage: its value for Australian health policy development and policy relevant research, Sydney2002: 20-21
      2. Dumovich J, Singh P. Physiology, Trauma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2020 Dec 24]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK538478/

        • Barrett LW
        • Fear VS
        • Waithman JC
        • Wood FM
        • Fear MW.
        Understanding acute burn injury as a chronic disease.
        Burns & Trauma [Internet]. 2019 Dec 1; ([cited 2020 Dec 24]; 7(s41038-019-0163–2). Available from:)https://doi.org/10.1186/s41038-019-0163-2
        • Teasdale G
        • Jennett B.
        Assessment and prognosis of coma after head injury.
        Acta Neurochirurgica. 1976; 34: 45-55
        • Jain S
        • Iverson LM.
        Glasgow Coma Scale.
        StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL)2020 ([cited 2020 Nov 22]. Available from:)
        • Gabbe BJ
        • Lyons RA
        • Lecky FE
        • Bouamra O
        • Woodford M
        • Coats TJ
        • et al.
        Comparison of Mortality Following Hospitalisation for Isolated Head Injury in England and Wales, and Victoria, Australia.
        PLoS One [Internet]. 2011 May 31; ([cited 2020 Nov 22]; 6(5). Available from:)
        • Beck B
        • Cameron PA
        • Braaf S
        • Nunn A
        • Fitzgerald MC
        • Judson RT
        • et al.
        Traumatic spinal cord injury in Victoria, 2007–2016.
        The Medical Journal of Australia. 2019 Apr 29; 210: 360-366
        • O'Rourke MC
        • Landis R
        • Burns B.
        Blunt Abdominal Trauma.
        StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL)2020 ([cited 2020 Dec 28]. Available from:)
        • Pj B
        • Ra N
        • Ab van V
        • J S
        Abdominal ultrasound as a reliable indicator for conclusive laparotomy in blunt abdominal trauma.
        J Trauma. 1993 Jan 1; 34: 27-31
        • Jansen JO
        • Yule SR
        • Loudon MA
        Investigation of blunt abdominal trauma.
        BMJ. 2008 Apr 24; 336: 938-942
        • Blakely T
        • Salmond C.
        Probabilistic record linkage and a method to calculate the positive predictive value.
        Int J Epidemiol. 2002 Dec 1; 31: 1246-1252
        • Dusetzina SB
        • Tyree S
        • Meyer A-M
        • Meyer A
        • Green L
        • Carpenter WR.
        An Overview of Record Linkage Methods [Internet]. Linking Data for Health Services Research: A Framework and Instructional Guide [Internet].
        Agency for Healthcare Research and Quality (US). 2014; ([cited 2020 Jul 1]. Available from:)
        • Copes WS
        • Champion HR
        • Sacco WJ
        • Lawnick MM
        • Keast SL
        • Bain LW.
        The Injury Severity Score revisited.
        J Trauma [Internet]. 1988; 28 (Available from:)https://doi.org/10.1097/00005373-198801000-00010
      3. EuroQol G.EuroQol–a new facility for the measurement of health-related quality of life.
        Health policy (Amsterdam, Netherlands). 1990; 16: 199
        • Williamson OD
        • Gabbe BJ
        • Sutherland AM
        • Hart MJ
        Group on behalf of the VOTORP. Does recall of preinjury disability change over time?.
        Injury Prevention. 2013 Aug 1; 19: 238-243
      4. Bernell S, Howard SW. Use Your Words Carefully: What Is a Chronic Disease? Front Public Health [Internet]. 2016 [cited 2020 Apr 26]; 4. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2016.00159/full

        • Tonelli M
        • Wiebe N
        • Fortin M
        • Guthrie B
        • Hemmelgarn BR
        • James MT
        • et al.
        Methods for identifying 30 chronic conditions: application to administrative data.
        BMC Medical Informatics and Decision Making. 2015 Apr 17; 15: 31
        • Kim HT.
        Cumulative incidence in competing risks data and competing risks regression analysis.
        Clin Cancer Res. 2007 Jan 15; 13: 559-565
        • Fine JP
        • Gray RJ.
        A Proportional Hazards Model for the Subdistribution of a Competing Risk.
        Journal of the American Statistical Association. 1999 Jun 1; 94: 496-509
      5. Australian Institute of Health and Welfare. Cancer in Australia 2019, Data [Internet]. Australian Institute of Health and Welfare. [cited 2020 Jul 3]. Available from: https://www.aihw.gov.au/reports/cancer/cancer-in-australia-2019/data

      6. Australian Institute of Health and Welfare. Cardiovascular disease, Data [Internet]. Australian Institute of Health and Welfare. [cited 2020 Jul 3]. Available from: https://www.aihw.gov.au/reports/heart-stroke-vascular-disease/cardiovascular-health-compendium/data

        • Bauman WA
        • Korsten MA
        • Radulovic M
        • Schilero GJ
        • Wecht JM
        • Spungen AM.
        31st G. Heiner Sell Lectureship: Secondary Medical Consequences of Spinal Cord Injury.
        Top Spinal Cord Inj Rehabil. 2012; 18: 354-378
      7. Department of Health & Human services. Specialist rehabilitation in Victoria [Internet]. Department of Health & Human Services; [cited 2021 Feb 10 ]. Available from: https://www2.health.vic.gov.au:443/hospitals-and-health-services/patient-care/rehabilitation-complex-care/specialist-rehabilitation

        • Parent S
        • Barchi S
        • LeBreton M
        • Casha S
        • Fehlings MG.
        The Impact of Specialized Centers of Care for Spinal Cord Injury on Length of Stay, Complications, and Mortality: A Systematic Review of the Literature.
        J Neurotrauma. 2011 Aug; 28: 1363-1370
        • Chang F
        • Zhang Q
        • Xie H
        • Yang Y
        • Sun M
        • Wu A
        • et al.
        Effects of a rehabilitation program for individuals with chronic spinal cord injury in Shanghai, China.
        BMC Health Services Research. 2020 Apr 15; 20: 298
        • Noonan VK
        • Chan E
        • Santos A
        • Soril L
        • Lewis R
        • Singh A
        • et al.
        Traumatic Spinal Cord Injury Care in Canada: A Survey of Canadian Centers.
        Journal of Neurotrauma. 2017 Apr 1; 34: 2848-2855
        • Dikmen SS
        • Machamer JE
        • Powell JM
        • Temkin NR.
        Outcome 3 to 5 years after moderate to severe traumatic brain injury.
        Arch Phys Med Rehabil. 2003 Oct; 84: 1449-1457
        • Ekegren CL
        • Braaf S
        • Ameratunga S
        • Ponsford J
        • Nunn A
        • Cameron P
        • et al.
        Adaptation, self-motivation and support services are key to physical activity participation three to five years after major trauma: a qualitative study.
        J Physiother. 2020 Jul; 66: 188-195
        • Braaf S
        • Ameratunga S
        • Ponsford J
        • Cameron P
        • Collie A
        • Harrison J
        • et al.
        Traumatic injury survivors’ perceptions of their future: a longitudinal qualitative study.
        Disabil Rehabil. 2020 Sep; 42: 2707-2717
        • Phillips AA
        • Krassioukov AV.
        Contemporary Cardiovascular Concerns after Spinal Cord Injury: Mechanisms, Maladaptations, and Management.
        J Neurotrauma. 2015 Dec 15; 32: 1927-1942
        • Adriaansen JJE
        • Ruijs LEM
        • van Koppenhagen CF
        • van Asbeck FWA
        • Snoek GJ
        • van Kuppevelt D
        • et al.
        Secondary health conditions and quality of life in persons living with spinal cord injury for at least ten years.
        J Rehabil Med. 2016 Nov 11; 48: 853-860
        • Piatt JA
        • Nagata S
        • Zahl M
        • Li J
        • Rosenbluth JP
        Problematic secondary health conditions among adults with spinal cord injury and its impact on social participation and daily life.
        J Spinal Cord Med. 2016 Nov; 39: 693-698
        • Jensen MP
        • Truitt AR
        • Schomer KG
        • Yorkston KM
        • Baylor C
        • Molton IR.
        Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review.
        Spinal Cord. 2013 Dec; 51: 882-892
      8. AIHW. Hip fracture incidence and hospitalisations in Australia 2015–16 [Internet]. Australian Institute of Health and Welfare. 2018 [cited 2021 Oct 25]. Available from: https://www.aihw.gov.au/reports/injury/hip-fracture-incidence-in-australia-2015-16/contents/table-of-contents

      9. AIHW. Estimating the prevalence of osteoporosis in Australia [Internet]. Australian Institute of Health and Welfare. 2014 [cited 2021 Oct 25]. Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/estimating-the-prevalence-of-osteoporosis-in-austr/contents/table-of-contents