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Mortality and health-related quality of life following injuries and associated factors: a cohort study in Chandigarh, North India
  1. Jagnoor Jagnoor1,2,
  2. Shankar Prinja3,
  3. Ha Nguyen4,5,
  4. Belinda J Gabbe6,
  5. Margaret Peden7,
  6. Rebecca Q Ivers2,4
  1. 1 Injury Division, The George Institute for Global Health, New Delhi, India
  2. 2 School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
  3. 3 School of Public Health, Post Graduate Institute of Medical Education and Research School of Public Health, Chandigarh, Punjab, India
  4. 4 Injury Division, The George Institute for Global Health, Sydney, New South Wales, Australia
  5. 5 John Walsh Centre for Rehabilitation Research, The University of Sydney, Sydney, New South Wales, Australia
  6. 6 Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  7. 7 The George Institute for Global Health UK, Oxford, Oxfordshire, UK
  1. Correspondence to Dr Jagnoor Jagnoor, Injury Division, The George Institute for Global Health, New Delhi 110025, India; jjagnoor{at}


Introduction Injuries are among the 10 leading causes of deaths worldwide. In recent years, the quality and reporting of injury mortality has improved but little or no data are available on the morbidity burden and impact of non-fatal injuries in India. This study evaluates health recovery status postinjury, identifying predictors of recovery in North India.

Methods Prospective cohort study recruiting patients from one tertiary-level and two secondary-level hospitals in North India between April and June 2014 hospitalised due to any injury. Health-related quality of life was assessed at baseline and at 1-month, 2-month, 4-month and 12-month postinjury using the EuroQol five-dimensional (EQ-5D-5L) questionnaire. Multivariable linear regressions with generalised estimating equations were used to examine the relationship between sociodemographic and injury-related factors with the EQ-5D-5L single utility score and the visual analogue scale (VAS) score.

Results A total of 2416 eligible patients aged ≥18 years were enrolled in the study. Of these, 2150 (74%) completed baseline and all four follow-up EQ-5D-5L questionnaires. Almost 7% (n=172) patients died by the first follow-up and the overall mortality at 12 months was 9% (n=176). Both EQ-5D-5L utility and VAS scores dropped significantly at 1-month postinjury but gradually improved at 2, 4 and 12 months. Severe injuries, defined as those requiring a hospital stay of ≥7 days, were associated with lower utility scores at 1-month, 2-month and 4-month follow-ups (p<0.001).

Conclusion This is the first study to examine health outcomes following injuries in India. The findings highlight the need to understand the social, psychological and biological factors influencing recovery outcomes. High mortality following discharge emphasises the need to invest in secondary and tertiary injury prevention in India.

  • injury diagnosis
  • quality of life
  • mortality
  • cohort study
  • multiple injury
  • clinical care

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  • Contributors JJ incepted the study design. SP was responsible for conducting the study. HN led the analysis. All co-authors contributed to the data interpretation and writing of the manuscript.

  • Funding The study was funded by the Road Traffic Injury Research Network, small grants 2015.

  • Competing interests No, there are no competing interests for any author.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval for the study was granted by the institutional ethics committee at the Postgraduate Institute for Medical Education and Research (Approval No.: PGI/IEC/2014/2262), and administrative approvals were sought at each participating hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.