New Zealand's Prospective Outcomes of Injury Study-10 years on (POIS-10): descriptive outcomes to 12 years post-injury

BACKGROUND

The 'Prospective Outcomes of Injury Study-10 years on' (POIS-10) aims to contribute to improving long-term disability, health and well-being outcomes for injured New Zealanders. This brief report describes recruitment, characteristics and key outcomes to 12 years post-injury.

METHODS

Between 2007 and 2009, the study recruited 2856 people, including 566 Māori, from New Zealand's Accident Compensation Corporation's entitlement claims register. People experienced a range of injury types, causes and settings; 25% had been hospitalised for their injury. POIS-10 data were primarily collected via interviewer-administered structured questionnaires.

RESULTS

Of the original participants, 2068 (92%) were eligible for follow-up in POIS-10. Of these, 1543 (75%) people participated between March 2020 and July 2021, including 240 Māori. Half of the participants (n=757; 50%) reported ongoing problems attributed to their injury 12 years earlier. Most reported difficulties with items assessing disability (WHO Disability Assessment Schedule II). For health-related quality of life (HRQoL), measured using the EQ-5D-5L, the prevalence of problems was higher 12 years post-injury compared with 12 months post-injury for four of five dimensions. Importantly, the prevalence of problems did not reduce to pre-injury levels for any HRQoL dimension.

DISCUSSION

POIS-10 highlights the importance of early post-injury interventions to improve health, disability and well-being outcomes of injured New Zealanders.

The role of intersection and street design on severity of bicycle-motor vehicle crashes

Background

Safety concerns are a major barrier to cycling. Intersection and street design variables such as intersection angles and street width might contribute to the severity of crashes and the safety concerns. In this study we examined whether these design variables were associated with bicycle-motor vehicle crashes (BMVC) severity.

Methods

Using the geographical information system and latitudes/longitudes recorded by the police using a global positioning device, we extracted intersection angles, street width, bicycle facilities, posted speed limits and annual average daily traffic from 3266 BMVC data from New York City police records. Additional variables about BMVC, including age and sex of the bicyclist, time of the day, road surface conditions, road character, vehicle type and injury severity, were obtained from police reports. Injury severity was classified as severe (incapacitating or killed) or non-severe (non-incapacitating, possible injury). The associations between injury severity and environment design variables were examined using multivariate log-binomial regression model.

Findings

Compared with crashes at orthogonal intersections, crashes at non-orthogonal intersections had 1.37 times (95% CI 1.05 to 1.80) and non-intersection street segments had 1.31 times (95% CI 1.01 to 1.70) higher risk of a severe injury. Crashes that involved a truck or a bus were twice as likely to result in a severe injury outcome; street width was not significantly associated with injury severity.

Conclusion

Crashes at non-orthogonal intersections and non-intersection segments are more likely to result in higher injury severity. The findings can be used to improve road design and develop effective safety interventions.

Subsequent Injury Study (SInS): Improving outcomes for injured New Zealanders

BACKGROUND

Subsequent injury (SI) is a major contributor to disability and costs for individuals and society.

AIM

To identify modifiable risk factors predictive of SI and SI health and disability outcomes and costs.

OBJECTIVES

To (1) describe the nature of SIs reported to New Zealand's no-fault injury insurer (the Accident Compensation Corporation (ACC)); (2) identify characteristics of people underaccessing ACC for SI; (3) determine factors predicting or protecting against SI; and (4) investigate outcomes for individuals, and costs to society, in relation to SI.

DESIGN

Prospective cohort study.

METHODS

Previously collected data will be linked including data from interviews undertaken as part of the earlier Prospective Outcomes of Injury Study (POIS), ACC electronic data and national hospitalisation data about SI. POIS participants (N=2856, including 566 Māori) were recruited via ACC's injury register following an injury serious enough to warrant compensation entitlements. We will examine SI over the following 24 months for these participants using descriptive and inferential statistics including multivariable generalised linear models and Cox's proportional hazards regression.

DISCUSSION

Subsequent Injury Study (SInS) will deliver information about the risks, protective factors and outcomes related to SI for New Zealanders. As a result of sourcing injury data from New Zealand's 'all injury' insurer ACC, SInS includes people who have been hospitalised and not hospitalised for injury. Consequently, SInS will provide insights that are novel internationally as other studies are usually confined to examining trauma registries, specific injuries or injured workers who are covered by a workplace insurer rather than a 'real-world' injury population.

Prevalence, recovery patterns and predictors of quality of life and costs after non-fatal injury: the Brabant Injury Outcome Surveillance (BIOS) study

INTRODUCTION

Trauma is a major public health problem worldwide that leads to high medical and societal costs. Overall, improved understanding of the full spectrum of the societal impact and burden of injury is needed. The main purpose of the Brabant Injury Outcome Surveillance (BIOS) study is to provide insight into prevalence, predictors and recovery patterns of short-term and long-term health-related quality of life (HRQoL) and costs after injury.

MATERIALS AND METHODS

This is a prospective, observational, follow-up cohort study in which HRQoL, psychological, social and functional outcome, and costs after trauma will be assessed during 24 months follow-up within injured patients admitted in 1 of 10 hospitals in the county Noord-Brabant, the Netherlands. Data will be collected by self-reported questionnaires at 1 week (including preinjury assessment), and 1, 3, 6, 12 and 24 months after injury. If patients are not capable of filling out the questionnaires, proxies will be asked to participate. Also, information about mechanism and severity of injury, comorbidity and indirect and direct costs will be collected. Mixed models will be used to examine the course of HRQoL, functional and psychological outcome, costs over time and between different groups, and to identify predictors for poor or good outcome.

RELEVANCE

This study should make a substantial contribution to the international collaborative effort to assess the societal impact and burden of injuries more accurately. The BIOS results will also be used to develop an outcome prediction model for outcome evaluation including, besides the classic fatal, non-fatal outcome.

TRIAL REGISTRATION NUMBER

NCT02508675.