Health-related quality of life (Hrqol) outcomes following injury in childhood and adolescence using euroqol (eq-5d) responses with pooled longitudinal data

Joanna Dipnall, Frederick P Rivara, Ronan Lyons, Shanthi Ameratunga, Mariana Brussoni, Fiona Lecky, Clare Bradley, Ben Beck, Jane Lyons, Amy Schneeberg, James Harrison, Belinda Gabbe

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2 Citations (Scopus)


Background: Injury is a leading contributor to the global disease burden in children, affecting their health-related quality of life (HRQoL)—yet valid estimates of burden are absent. Methods: This study pooled longitudinal data from five cohort studies of pediatric injury survivors (5– 17 years) at baseline, 1-, 4-, 6-, 12-, and 24-months (n = 2334). HRQoL post-injury was measured using the 3-level EQ-5D utility score (EQ-5D) and five health states (mobility, self-care, activity, pain, anxiety and depression (anxiety)). Results: Mean EQ-5D post-injury did not return to baseline level (0.95) by 24 months (0.88) and was lower for females over time (−0.04, 95%CI −0.05, −0.02). A decreased adjusted risk ratio over time (ARR) was observed for intentional injuries (pain: 0.85, 95%CI 0.73,0.98; anxiety: 0.62, 95%CI 0.49,0.78); spinal cord injuries (mobility: 0.61, 95%CI 0.45,0.83), self-care: 0.76, 95%CI 0.63,0.91, activity: 0.64, 95%CI 0.47,0.88); moderate/severe traumatic brain injury (activity: 0.83, 95%CI 0.71,0.96). ARRs were also low for certain fractures, with various health states affected. Conclusions: HRQoL outcomes over time for children and adolescents post-injury differed across key demographic and injury related attributes. HRQoL did not reach levels consistent with full health by 24 months with recovery plateauing from 6 to 24 months. Tailored interventions are required to respond to the varying post-injury recovery trajectories in this population.

Original languageEnglish
Article number10156
Number of pages19
JournalInternational Journal of Environmental Research and Public Health
Issue number19
Publication statusPublished - 1 Oct 2021


  • Adolescents
  • Children
  • Disability
  • EQ-5D
  • Health outcomes
  • Health-related quality of life
  • Injury
  • Pediatric
  • Trauma

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