The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Abstract

Background: A better understanding of how chronic physical health conditions affect long-term outcomes following injury is essential for quantifying the burden of serious orthopaedic injuries. We aimed to describe the association between the presence of post-injury chronic physical health conditions and (i) the change in health status from before injury to six different follow-up time points after injury; and (ii) survival time. Methods: A cohort study was conducted using linked data from the REcovery after Serious Trauma: Outcomes, Resource Use, and Patient Experiences study, the Victorian Registry of Births, Deaths and Marriages (BDM) (2009–2017), the victorian admitted episodes dataset (2009–2017) and the victorian emergency minimum dataset (2009–2017). Adults (≥ 18 years old) with serious orthopaedic injuries who survived to discharge from their trauma admission were included. Multivariable linear regression analysis was conducted to evaluate the association between post-injury chronic physical health conditions and the mean change in health status (EuroQol-Visual Analogue Scale) from before injury to six follow-up time points post-injury. Survival analysis was conducted to estimate the probability of survival for people with and without chronic physical health conditions following injury. Results: Out of 894 participants, 177 (19.8%) had at least one chronic physical health condition recorded up to five years post-injury. People with post-injury conditions reported a greater mean decline in health status than people without post-injury conditions (difference, (95% CI): −6.9 (−9.7, −4.2), p = 0.01). Over the study period, almost six times as many people with chronic physical health conditions post-injury died as people without these conditions (AHR (95% CI): 5.7 (2.9, 11.3), p < 0.01). Conclusions: Chronic physical conditions after serious orthopaedic injuries were associated with a lower survival probability and a deteriorating health status. Orthopaedic injury survivors may benefit from early detection and treatment of chronic conditions.