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Predictors of health-related quality of life following injury in childhood and adolescence: a pooled analysis
  1. Joanna F Dipnall1,2,
  2. Frederick P Rivara3,
  3. Ronan A Lyons1,4,5,
  4. Shanthi Ameratunga1,6,7,
  5. Mariana Brussoni8,9,
  6. Fiona E Lecky10,11,
  7. Clare Bradley12,13,
  8. Ben Beck1,
  9. Jane Lyons4,
  10. Amy Schneeberg9,14,
  11. James E Harrison15,
  12. Belinda J Gabbe1,4
  1. 1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
  3. 3Departments of Pediatrics and Epidemiology, and the Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
  4. 4Health Data Research UK, Swansea University, Swansea, UK
  5. 5National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
  6. 6School of Population Health, University of Auckland, Auckland, New Zealand
  7. 7Kidz First Hospital and Population Health Directorate, Counties Manukau District Health Board, Auckland, New Zealand
  8. 8Department of Pediatrics, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  9. 9British Columbia Injury Research and Prevention Unit, British Columbia Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
  10. 10Centre for Urgent and Emergency Care Research, School of Health and Related Research, University of Sheffield, Sheffield, UK
  11. 11Emergency Department, Salford Royal Hospital, Salford, UK
  12. 12South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  13. 13College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  14. 14School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  15. 15Flinders Institute for Health and Medical Research, Flinders University, Adelaide, South Australia, Australia
  1. Correspondence to Dr Joanna F Dipnall, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; jo.dipnall{at}monash.edu

Abstract

Background Injury is a leading contributor to the global disease burden in children and places children at risk for adverse and lasting impacts on their health-related quality of life (HRQoL) and development. This study aimed to identify key predictors of HRQoL following injury in childhood and adolescence.

Methods Data from 2259 injury survivors (<18 years when injured) were pooled from four longitudinal cohort studies (Australia, Canada, UK, USA) from the paediatric Validating Injury Burden Estimates Study (VIBES-Junior). Outcomes were the Paediatric Quality of Life Inventory (PedsQL) total, physical, psychosocial functioning scores at 1, 3–4, 6, 12, 24 months postinjury.

Results Mean PedsQL total score increased with higher socioeconomic status and decreased with increasing age. It was lower for transport-related incidents, ≥1 comorbidities, intentional injuries, spinal cord injury, vertebral column fracture, moderate/severe traumatic brain injury and fracture of patella/tibia/fibula/ankle. Mean PedsQL physical score was lower for females, fracture of femur, fracture of pelvis and burns. Mean PedsQL psychosocial score was lower for asphyxiation/non-fatal submersion and muscle/tendon/dislocation injuries.

Conclusions Postinjury HRQoL was associated with survivors’ socioeconomic status, intent, mechanism of injury and comorbidity status. Patterns of physical and psychosocial functioning postinjury differed according to sex and nature of injury sustained. The findings improve understanding of the long-term individual and societal impacts of injury in the early part of life and guide the prioritisation of prevention efforts, inform health and social service planning to help reduce injury burden, and help guide future Global Burden of Disease estimates.

  • disability
  • public health
  • longitudinal

Data availability statement

Data are available on reasonable request. The data included in this project are not freely available. Requests for access to data from the participating datasets would need to be directed to the relevant data custodian.

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Data availability statement

Data are available on reasonable request. The data included in this project are not freely available. Requests for access to data from the participating datasets would need to be directed to the relevant data custodian.

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Footnotes

  • Twitter @mbrussoni, @DrBenBeck, @EmergTrauma

  • Contributors All authors conceptualised and designed the study. JFD carried out the initial analyses, wrote the original draft of the manuscript and reviewed and edited the final manuscript. BJG, FPR, RAL and MB verified the underlying data. All authors critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. JFD accepts full responsibility for the work and/or the conduct of the study related to this manuscript, had access to the data, and controlled the decision to publish.

  • Funding VIBES-Junior project: National Health and Medical Research Council of Australia (NHMRC-APP1142325); UKBOI: Policy Research Programme, Department of Health (#0010009); VSTR: Department of Health and Human Services (Victoria), Transport Accident Commission (TAC); CHAI: US Centers for Disease Control and Prevention; BCCH-LIO: Canadian Institutes of Health Research (#TIR-104028), Michael Smith Foundation for Health Research. Mariana Brussoni: BCCH Research Institute and Michael Smith Foundation for Health Research Scholar Award. Belinda Gabbe: Australian Research Council Future Fellowship (FT170100048).

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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