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Chronic Physical Health Conditions After Injury: A Comparison of Prevalence and Risk in People With Orthopedic Major Trauma and Other Types of Injury

  • Asmare Yitayeh Gelaw
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, 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, Melbourne, Australia

    Health Data Research UK, Swansea University Medical School, Swansea University, Wales, UK
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  • Christina L. Ekegren
    Correspondence
    Corresponding author Christina L. Ekegren, PhD, Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University Peninsula Campus, McMahons Rd, Frankston, VIC 3199, Australia.
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

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

    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

      Objectives

      To determine (1) the prevalence of chronic physical health conditions reported preinjury, at the time of injury, up to 1 year postinjury, and 1 to 5 years postinjury; and (2) the risk of chronic physical health conditions reported 1 to 5 years postinjury in people with orthopedic 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

      Major trauma patients (N=28,522) aged 18 years and older who were registered by the VSTR, with dates of injury from 2007 to 2016, and who survived to at least 1 year after injury, were included in this study. Major trauma cases were classified into 4 groups: (1) orthopedic injury, (2) severe traumatic brain injury (s-TBI), (3) spinal cord injury, and (4) other major trauma.

      Intervention

      Not applicable.

      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. Preinjury chronic conditions were most common in people with s-TBI (19.3%) and were least common in people with other types of major trauma (6.6%). The highest prevalence of new-onset conditions after injury was found in people with s-TBI (21.7%) and orthopedic major trauma (21.4%), whereas the lowest prevalence was found in people with other types of major trauma (9.2%). For the orthopedic injury group, there were no significant differences in the adjusted risk of conditions reported 1 to 5 years postinjury compared with other major trauma groups.

      Conclusions

      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 orthopedic and other types of major trauma. Long-term follow-up care after injury should include prevention and treatment of chronic conditions.

      Keywords

      List of abbreviations:

      BDM (Births, Deaths and Marriages), CIF (cumulative incidence function), CVD (cardiovascular disease), ED (emergency department), EQ-VAS (EuroQol-visual analog scale), ICD-10-AM (International Classification of Diseases, 10th Edition, Australian Modification), ISS (Injury Severity Score), SCI (spinal cord injury), s-TBI (severe traumatic brain injury), TBI (traumatic brain injury), VAED (Victorian Admitted Episodes Dataset), VEMD (Victorian Emergency Minimum Dataset), VSTR (Victorian State Trauma Registry)
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