Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Surgery, School of Medicine College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Traffic Inj Prev. 2022;23(1):40-45. doi: 10.1080/15389588.2021.1990895. Epub 2021 Nov 5.
Measuring the level of disability following trauma is a key step for secondary and tertiary level trauma prevention. It can give important evidence for decision-makers and program implementers on the need for establishing rehabilitation centers.
This is a longitudinal follow-up study on 235 road traffic injury survivors. Patients were followed for 12 months, and the outcome was ascertained using the brief WHODAS-II 12-item instrument at 1, 3, 6, and 12-months post-injury. The level of disability was divided into five groups from no disability to very severe based on their disability scores. Work status was assessed at each survey using a single question "are you back to work?" We employed a linear mixed model to identify disability scores changes over time and risk factors associated with disability. Statistically, a significant association was declared at < 0.05.
The overall mean disability score was 24.9 ± 11.3 at one month and 8.3 ± 6.4 after 12 months of injury. Disability score has decreased by 1.3 units over time during 12 months post-injury. Functional limitation persisted on 25-88% of participants at specific dimensions of disability at the end of the study. After a year of injury, 44% of participants didn't return to work. Injury severity score (β = 0.47, < 0.001, length of hospital stays (β = 0.88, < 0.005) and discharge against medical advice (β = 2.18, < 0.001) were found to be predictors of disability following road traffic injuries.
The current study demonstrated that, though there was a decrease in disability score over time, a significant number of participants were with some degree of limitation after one year of injury, and nearly half of them didn't return to work. Shortening of long waiting times and counseling services need to be considered by the hospital. Community-based Rehabilitation centers (CBR) should be expanded. Further study should be conducted to uncover the reasons for preferring traditional bone fixers over medical management.
衡量创伤后残疾程度是二级和三级创伤预防的关键步骤。它可以为决策者和项目实施者提供重要证据，说明是否需要建立康复中心。
这是一项针对 235 名道路交通伤害幸存者的纵向随访研究。患者在 12 个月内接受随访，并在受伤后 1、3、6 和 12 个月使用简短 WHODAS-II 12 项工具确定结局。根据残疾评分，将残疾程度分为无残疾至极重度 5 组。在每次调查中，使用一个问题“你是否重返工作岗位？”评估工作状态。我们采用线性混合模型来确定残疾评分随时间的变化和与残疾相关的危险因素。统计学上，显著性关联定义为 <0.05。
一个月时总体平均残疾评分为 24.9±11.3，12 个月时为 8.3±6.4。在 12 个月的受伤后期间，残疾评分随时间减少了 1.3 个单位。在研究结束时，特定残疾维度上仍有 25-88%的参与者存在功能限制。受伤一年后，44%的参与者未重返工作岗位。损伤严重程度评分（β=0.47，<0.001）、住院时间（β=0.88，<0.005）和出院后医疗咨询（β=2.18，<0.001）是道路交通伤害后残疾的预测因素。
本研究表明，尽管残疾评分随时间有所下降，但在受伤一年后，仍有相当一部分参与者存在一定程度的受限，其中近一半人未重返工作岗位。医院需要考虑缩短长时间的等待时间和咨询服务。应扩大社区康复中心（CBR）。应进一步研究以揭示选择传统骨科固定器而非医疗管理的原因。
