Higher mortality risk among injured individuals in a population-based matched cohort study

Rebecca J. Mitchell, Cate M. Cameron, Rod McClure

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Improved understanding of long-term mortality attributable to injury is needed to accurately inform injury burden studies. This study aims to quantify and describe mortality attributable to injury 12 months after an injury-related hospitalisation in Australia.

Method: A population-based matched cohort study using linked hospital and mortality data from three Australian states during 2008-2010 was conducted. The injured cohort included individuals ≥18 years who had an injury-related hospital admission in 2009. A comparison cohort of non-injured people was obtain by randomly selecting from the electoral roll. This comparison group was matched 1:1 on age, gender and postcode of residence. Pre-index injury health service use and 12-month mortality were examined. Adjusted mortality rate ratios (MRR) and attributable risk were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival.

Results: Injured individuals were almost 3 times more likely to die within 12 months following an injury (MRR 2.90; 95% CI: 2.76-3.04). Individuals with a traumatic brain injury (MRR 7.58; 95% CI: 5.92-9.70) or injury to internal organs (MRR 7.38; 95% CI: 5.90-9.22) were 7 times more likely to die than the non-injured group. Injury was likely to be a contributory factor in 92% of mortality within 30 days and 66% of mortality at 12 months following the index injury hospital admission. Adjusted mortality rate ratios varied by type of cause-specific death, with MRR highest for injury-related deaths.

Conclusions: There are likely chronic consequences of sustaining a traumatic injury. Longer follow-up post-discharge is needed to consider deaths likely to be attributable to the injury. Better enumeration of long-term injury-related mortality will have the potential to improve estimates of injury burden.

LanguageEnglish
Article number150
Pages1-9
Number of pages9
JournalBMC Public Health
Volume17
Issue number1
DOIs
Publication statusPublished - 2 Feb 2017

Fingerprint

Cohort Studies
Mortality
Wounds and Injuries
Population
Hospital Mortality
Health Services
Cause of Death
Hospitalization
Research Design
Odds Ratio

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • injury
  • mortality
  • comorbidity
  • hospitalisation
  • survival

Cite this

@article{c06aaf718b9644e78952bc73bc0161a2,
title = "Higher mortality risk among injured individuals in a population-based matched cohort study",
abstract = "Background: Improved understanding of long-term mortality attributable to injury is needed to accurately inform injury burden studies. This study aims to quantify and describe mortality attributable to injury 12 months after an injury-related hospitalisation in Australia. Method: A population-based matched cohort study using linked hospital and mortality data from three Australian states during 2008-2010 was conducted. The injured cohort included individuals ≥18 years who had an injury-related hospital admission in 2009. A comparison cohort of non-injured people was obtain by randomly selecting from the electoral roll. This comparison group was matched 1:1 on age, gender and postcode of residence. Pre-index injury health service use and 12-month mortality were examined. Adjusted mortality rate ratios (MRR) and attributable risk were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival. Results: Injured individuals were almost 3 times more likely to die within 12 months following an injury (MRR 2.90; 95{\%} CI: 2.76-3.04). Individuals with a traumatic brain injury (MRR 7.58; 95{\%} CI: 5.92-9.70) or injury to internal organs (MRR 7.38; 95{\%} CI: 5.90-9.22) were 7 times more likely to die than the non-injured group. Injury was likely to be a contributory factor in 92{\%} of mortality within 30 days and 66{\%} of mortality at 12 months following the index injury hospital admission. Adjusted mortality rate ratios varied by type of cause-specific death, with MRR highest for injury-related deaths. Conclusions: There are likely chronic consequences of sustaining a traumatic injury. Longer follow-up post-discharge is needed to consider deaths likely to be attributable to the injury. Better enumeration of long-term injury-related mortality will have the potential to improve estimates of injury burden.",
keywords = "injury, mortality, comorbidity, hospitalisation, survival",
author = "Mitchell, {Rebecca J.} and Cameron, {Cate M.} and Rod McClure",
note = "Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",
year = "2017",
month = "2",
day = "2",
doi = "10.1186/s12889-017-4087-0",
language = "English",
volume = "17",
pages = "1--9",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "Springer, Springer Nature",
number = "1",

}

Higher mortality risk among injured individuals in a population-based matched cohort study. / Mitchell, Rebecca J.; Cameron, Cate M.; McClure, Rod.

In: BMC Public Health, Vol. 17, No. 1, 150, 02.02.2017, p. 1-9.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Higher mortality risk among injured individuals in a population-based matched cohort study

AU - Mitchell, Rebecca J.

AU - Cameron, Cate M.

AU - McClure, Rod

N1 - Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2017/2/2

Y1 - 2017/2/2

N2 - Background: Improved understanding of long-term mortality attributable to injury is needed to accurately inform injury burden studies. This study aims to quantify and describe mortality attributable to injury 12 months after an injury-related hospitalisation in Australia. Method: A population-based matched cohort study using linked hospital and mortality data from three Australian states during 2008-2010 was conducted. The injured cohort included individuals ≥18 years who had an injury-related hospital admission in 2009. A comparison cohort of non-injured people was obtain by randomly selecting from the electoral roll. This comparison group was matched 1:1 on age, gender and postcode of residence. Pre-index injury health service use and 12-month mortality were examined. Adjusted mortality rate ratios (MRR) and attributable risk were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival. Results: Injured individuals were almost 3 times more likely to die within 12 months following an injury (MRR 2.90; 95% CI: 2.76-3.04). Individuals with a traumatic brain injury (MRR 7.58; 95% CI: 5.92-9.70) or injury to internal organs (MRR 7.38; 95% CI: 5.90-9.22) were 7 times more likely to die than the non-injured group. Injury was likely to be a contributory factor in 92% of mortality within 30 days and 66% of mortality at 12 months following the index injury hospital admission. Adjusted mortality rate ratios varied by type of cause-specific death, with MRR highest for injury-related deaths. Conclusions: There are likely chronic consequences of sustaining a traumatic injury. Longer follow-up post-discharge is needed to consider deaths likely to be attributable to the injury. Better enumeration of long-term injury-related mortality will have the potential to improve estimates of injury burden.

AB - Background: Improved understanding of long-term mortality attributable to injury is needed to accurately inform injury burden studies. This study aims to quantify and describe mortality attributable to injury 12 months after an injury-related hospitalisation in Australia. Method: A population-based matched cohort study using linked hospital and mortality data from three Australian states during 2008-2010 was conducted. The injured cohort included individuals ≥18 years who had an injury-related hospital admission in 2009. A comparison cohort of non-injured people was obtain by randomly selecting from the electoral roll. This comparison group was matched 1:1 on age, gender and postcode of residence. Pre-index injury health service use and 12-month mortality were examined. Adjusted mortality rate ratios (MRR) and attributable risk were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival. Results: Injured individuals were almost 3 times more likely to die within 12 months following an injury (MRR 2.90; 95% CI: 2.76-3.04). Individuals with a traumatic brain injury (MRR 7.58; 95% CI: 5.92-9.70) or injury to internal organs (MRR 7.38; 95% CI: 5.90-9.22) were 7 times more likely to die than the non-injured group. Injury was likely to be a contributory factor in 92% of mortality within 30 days and 66% of mortality at 12 months following the index injury hospital admission. Adjusted mortality rate ratios varied by type of cause-specific death, with MRR highest for injury-related deaths. Conclusions: There are likely chronic consequences of sustaining a traumatic injury. Longer follow-up post-discharge is needed to consider deaths likely to be attributable to the injury. Better enumeration of long-term injury-related mortality will have the potential to improve estimates of injury burden.

KW - injury

KW - mortality

KW - comorbidity

KW - hospitalisation

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=85011422777&partnerID=8YFLogxK

U2 - 10.1186/s12889-017-4087-0

DO - 10.1186/s12889-017-4087-0

M3 - Article

VL - 17

SP - 1

EP - 9

JO - BMC Public Health

T2 - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 150

ER -