Document Detail


A population-based cohort study of longer-term changes in health of car drivers involved in serious crashes.
MedLine Citation:
PMID:  16997425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: Evidence about the burden of disability after motor vehicle crashes has relied primarily on trauma center-based studies. We examine the impact of serious crashes on the longer-term health of car drivers, independent of natural variation, in a population-based study in Auckland, New Zealand. METHODS: The study population comprised 218 car drivers surviving nonfatal crashes in Auckland, in which at least 1 occupant in the vehicle was admitted to a hospital, and a representative sample of 254 car drivers in the region, recruited from roadside surveys. All participants were interviewed at recruitment (subjects reported their precrash health) and 5 and 18 months later. The drivers' changes in health were obtained with a global health transition indicator and the Short Form-36, with analyses adjusting for potential confounders. RESULTS: Compared with 7% of drivers in the comparison group, 43% of crash drivers admitted to the hospital (adjusted odds ratio 10.4; 95% confidence interval 5.5 to 19.6) and 20% of those not admitted (odds ratio 3.3; 95% confidence interval 1.4 to 8.3) reported that their overall health at 18-month follow-up was worse than at baseline (precrash). Among the drivers reporting worsened health, prospectively ascertained Short Form-36 scores revealed greater reductions in physical health in those admitted after the crash, but these scores improved from 5 to 18 months. In contrast, mental and general health scores worsened from 5 to 18 months in admitted and nonadmitted crash drivers. CONCLUSION: A substantial proportion of drivers surviving serious crashes experience reductions in longer-term health, a burden likely to be underappreciated among those not admitted to a hospital. Emergency departments could serve as useful settings in which to develop and validate clinical decision rules that can help target services for crash survivors at increased risk of adverse outcomes.
Authors:
Shanthi N Ameratunga; Robyn N Norton; Jennie L Connor; Elizabeth Robinson; Ian Civil; John Coverdale; Derrick Bennett; Rod T Jackson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-09-25
Journal Detail:
Title:  Annals of emergency medicine     Volume:  48     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-20     Completed Date:  2006-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  729-36     Citation Subset:  AIM; IM    
Affiliation:
Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. s.ameratunga@auckland.ac.nz
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic / statistics & numerical data*
Adolescent
Adult
Age Distribution
Aged
Case-Control Studies
Cohort Studies
Female
Health Status*
Hospitalization
Humans
Injury Severity Score
Male
Mental Health*
Middle Aged
New Zealand / epidemiology
Time Factors
Wounds and Injuries / classification*,  psychology
Comments/Corrections
Comment In:
Ann Emerg Med. 2006 Dec;48(6):737-8   [PMID:  16997420 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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