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澳大利亚道路交通事故中受轻伤的住院与非住院人员健康结局比较:一项前瞻性队列研究。

Comparison of health outcomes between hospitalised and non-hospitalised persons with minor injuries sustained in a road traffic crash in Australia: a prospective cohort study.

作者信息

Gopinath Bamini, Jagnoor Jagnoor, Harris Ian A, Nicholas Michael, Maher Christopher G, Casey Petrina, Blyth Fiona, Sindhusake Doungkamol, Cameron Ian D

机构信息

John Walsh Centre for Rehabilitation Research, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia.

出版信息

BMJ Open. 2015 Sep 24;5(9):e009303. doi: 10.1136/bmjopen-2015-009303.

Abstract

OBJECTIVES

This prospective cohort study aimed to investigate whether there are differences in health outcomes among persons with mild or moderate injuries who were hospitalised compared with those not hospitalised following a road traffic crash.

SETTING

Sydney Metropolitan, New South Wales, Australia.

PARTICIPANTS

Persons aged ≥18 years involved in a motor vehicle crash were surveyed at baseline (n=364), and at 12 (n=284) and 24 months (n=252). A telephone-administered questionnaire obtained information on a range of socioeconomic, and preinjury and postinjury psychological and heath characteristics of all participants.

PRIMARY OUTCOME MEASURE

Participants who reported admission to hospital for 24 h or more (but less than 7 days) after the crash were classified as being hospitalised; those admitted for less than 24 h were classified as non-hospitalised.

RESULTS

Around 1 in 5 participants (19.0%) were hospitalised for ≥24 h after the crash. After adjusting for age and sex, hospitalised participants compared with those not hospitalised had approximately 2.6 units (p=0.01) lower Short Form-12 Physical Component Summary (SF-12 PCS) scores (poorer physical well-being) and approximately 4.9 units lower European Quality of Life visual analogue scale (EQ-VAS) scores (p=0.05), 12 months later. After further adjusting for education level, whiplash, fracture and injury severity score, participants who were hospitalised had approximately 3.3 units lower SF-12 PCS (p=0.04), 12 months later. The association with EQ-VAS did not persist after multivariable adjustment. No significant differences were observed between the 2 groups in health outcomes at 24-month follow-up.

CONCLUSIONS

These findings indicate that long-term health status is unlikely to be influenced by hospitalisation status after sustaining a mild/moderate injury in a vehicle-related crash.

摘要

目的

这项前瞻性队列研究旨在调查在道路交通事故后,与未住院的轻度或中度受伤者相比,住院的轻度或中度受伤者的健康结局是否存在差异。

地点

澳大利亚新南威尔士州悉尼大都市地区。

参与者

年龄≥18岁的机动车事故参与者在基线时(n = 364)、12个月时(n = 284)和24个月时(n = 252)接受了调查。通过电话调查问卷获取了所有参与者一系列社会经济、伤前和伤后心理及健康特征的信息。

主要结局指标

报告在事故发生后住院24小时或更长时间(但少于7天)的参与者被归类为住院;住院时间少于24小时的参与者被归类为未住院。

结果

约五分之一的参与者(19.0%)在事故发生后住院≥24小时。在调整年龄和性别后,与未住院的参与者相比,住院参与者在12个月后简短健康调查问卷12项身体成分汇总量表(SF - 12 PCS)得分低约2.6分(p = 0.01)(身体健康状况较差),欧洲生活质量视觉模拟量表(EQ - VAS)得分低约4.9分(p = 0.05)。在进一步调整教育水平、鞭打损伤、骨折和损伤严重程度评分后,住院参与者在12个月后SF - 12 PCS得分低约3.3分(p = 0.04)。多变量调整后,与EQ - VAS的关联不再存在。在24个月随访时,两组在健康结局方面未观察到显著差异。

结论

这些发现表明,在与车辆相关的事故中遭受轻度/中度损伤后,长期健康状况不太可能受到住院状态的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1e8/4593145/4dabff7d6a87/bmjopen2015009303f01.jpg

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