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Psychological morbidity and health-related quality of life after injury: multicentre cohort study

Christie, N.; Kendrick, D.; Sleney, J.; Joseph, S.; Morriss, R.; Beckett, K.; Coupland, C.; Kelllezi, B.; Kendrick, Denise; Kellezi, Blerina; Coupland, Carol; Beckett, Kate; Morriss, Richard; Joseph, Stephen; Sleney, Jude; Christe, Nicola; Maula, A.; Barnes, J.

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N. Christie

D. Kendrick

J. Sleney

S. Joseph

R. Morriss

K. Beckett

C. Coupland

B. Kelllezi

Denise Kendrick

Blerina Kellezi

Carol Coupland

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Kate Beckett
Occasional Associate Lecturer - Allied Health Professions

Richard Morriss

Stephen Joseph

Jude Sleney

Nicola Christe

A. Maula

J. Barnes


© 2016, The Author(s). Purpose: To demonstrate the impact of psychological morbidity 1month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in the UK to inform development of trauma care and rehabilitation services. Methods: Multicentre cohort study of 16–70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at recruitment and 1, 2, 4 and 12months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity 1month post-injury and MID in HRQoL over the 12months after injury. Results: A total of 668 adults participated. Follow-up rates were 77% (1month) and 63% (12months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1month and 58% at 12months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1month post-injury were independently associated with subsequent MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship between anxiety and HRQoL was not explained by factors measured in our study. Conclusions: Hospitalised injuries result in substantial reductions in HRQoL up to 12months later. Depression and anxiety early in the recovery period are independently associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving HRQoL post-injury.


Christie, N., Sleney, J., Joseph, S., Morriss, R., Beckett, K., Coupland, C., …Christe, N. (2017). Psychological morbidity and health-related quality of life after injury: multicentre cohort study. Quality of Life Research, 26(5), 1233-1250.

Journal Article Type Article
Acceptance Date Oct 13, 2016
Online Publication Date Oct 26, 2016
Publication Date May 1, 2017
Publicly Available Date Jan 16, 2017
Journal Quality of Life Research
Print ISSN 0962-9343
Electronic ISSN 1573-2649
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 26
Issue 5
Pages 1233-1250
Keywords unintentional injury, quality of life, depression, anxiety, cohort study
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