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

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

Abstract

© 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.

• Journal Article Type: Article
• Acceptance Date: Oct 13, 2016
• Online Publication Date: Oct 26, 2016
• Publication Date: May 1, 2017
• Deposit Date: Jan 16, 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
• DOI: https://doi.org/10.1007/s11136-016-1439-7
• Keywords: unintentional injury, quality of life, depression, anxiety, cohort study
• Public URL: https://uwe-repository.worktribe.com/output/886904
• Publisher URL: http://dx.doi.org/10.1007/s11136-016-1439-7
• Contract Date: Jan 16, 2017