Background/Aims Impacts of mild to moderate road traffic injury have often been underestimated. Few existing studies involve a wide spectrum of individuals with predominantly mild to moderate road traffic injuries and examine long-term outcomes after accounting for a broad range of contributing, confounding and compensation-related factors. This study examines 24-month health-related quality of life (QoL) outcomes in this setting.

Methods The Factors Influencing Social and Health Outcomes (FISH) study involved 2019 participants with non-catastrophic road traffic injury in Australia, using an inception cohort design with follow up at 6, 12 and 24 months. Data collection included preinjury, crash, injury, compensation-related factors, baseline physical and psychological status, and the EQ-5D-3L health-related QoL questionnaire before and after injury at baseline, 6, 12 and 24 months.

Results Long-term problems with pain, anxiety or depression and usual activities were common. Among participants without a problem pre-injury, 37% still reported pain, 28% reported anxiety/depression and 28% reported problems with usual activities after 24 months. Overall, most participants with long-term issues did not have the problem before injury. The strongest and/or most consistent preinjury or early post-injury explanatory factors for long-term QoL outcomes included baseline psychological status and recovery expectations, claimant status, measures of injury severity, involvement of spine, back or neck and pre-injury comorbidities.

Conclusions Recognition of a substantial potential for chronic problems after mild to moderate road traffic injury is essential to ensure that clinical management approaches and compensation schemes anticipate, minimize and address long-term problems, and detect potentially modifiable early targets for intervention.