Pre-injury health status of major trauma patients with orthopaedic injuries

Background
Determining the pre-injury health status of major trauma patients with orthopaedic injuries is important for evaluating the change from pre to post-injury health status.
Aims
To describe patients’ pre-injury health status reported 6, 12 and 24 months after orthopaedic major trauma and compare this with Australian normative values; determine the change in pre-injury health status in the first 24 months post-injury and identify factors associated with reporting better pre-injury health status.
Methods
A registry-based cohort study was conducted. Major trauma patients with orthopaedic injuries captured by the Victorian State Trauma Registry with a date of injury from January 2009 to December 2016 were included. Pre-injury
health status (measured using the EuroQol-Visual Analogue Scale (EQ-VAS)), reported 6, 12 and 24 months postinjury, was compared against Australian population normative values using independent sample t-tests. The Bland Altman method of comparison was used to determine the agreement between pre-injury EQ-VAS scores reported 6 to 12 and 6 to 24 months post-injury. Mixed-effects ordinal logistic regression was used to determine the predictors of reporting better pre-injury health status.
Results
A total of 3,071 patients were included. The median (IQR) pre-injury EQ-VAS score reported 6, 12 and 24 months after injury was 90 (85-100) out of 100. Participants’ mean pre-injury EQ-VAS scores reported 6, 12 and 24 months
post-injury were significantly higher than Australian population normative values (t = 28.6; p<0.001, t = 29.8; p<0.001 and t = 29.4, p<0.001) respectively. Pre-injury EQ-VAS scores reported 6 months post-injury agreed with pre-injury
EQ-VAS scores reported 12 and 24 months post-injury. People aged 35-44, 45-54 and 55-64 years, who were injured in intentional events, living with comorbidities and living in more socioeconomically advantaged areas had lower
odds of reporting better pre-injury EQ-VAS scores. Pedal cyclists, who were injured via high falls and striking, with compensable injuries, with more severe injuries and who were working/studying prior to injury had higher odds of
reporting better pre-injury EQ-VAS scores.
Discussion and conclusions

Major trauma patients with orthopaedic injuries reported better pre-injury health status compared to the Australian population. Pre-injury health status reported 6, 12 and 24 months post-injury did not differ and thus could be used interchangeably.