Quantifying the hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia

Rebecca J. Mitchell; Cate M. Cameron; Rod Mcclure

doi:10.1136/bmjopen-2016-013266

Quantifying the hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia

Rebecca J. Mitchell^*, Cate M. Cameron, Rod Mcclure

^*Corresponding author for this work

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15 Citations (Scopus)

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Abstract

Objectives To quantify the 12-month hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia.

Setting: New South Wales, Queensland and South Australia, Australia.

Participants: Individuals ≥18years who had an injury-related hospital admission in 2009 formed the injured cohort. The non-injured comparison cohort was randomly selected from the electoral roll and was matched 1:1 on age, gender and postcode of residence at the date of the index injury admission of their matched counterpart.

Primary outcome measures: Using linked emergency department presentation, hospital admission and mortality records from 1 January 2008 to 31 December 2010 for both the injured and non-injured cohorts, 12-month mortality and pre-index and post-index injury hospital service use was examined. Adjusted rate ratios and attributable risk were calculated.

Results: There were 167600 individuals injured in 2009 and admitted to hospital in New South Wales, South Australia or Queensland with a matched comparison. The injured cohort had 3 times higher proportion of having ≥1 comorbidity preinjury, higher preinjury hospital service use, and a higher 12-month mortality compared with a non-injured comparison group. The injured cohort had 2.20 (95% CI 2.12 to 2.28) times higher rate of hospital admissions in the 12months post the index injury admission compared with the non-injured comparison cohort. Injury was a likely contributory factor in at least 55% of hospitalisations within 12months of the index injury hospitalisation.

Conclusions: Individuals who had an injury-related hospitalisation had higher mortality and are hospitalised at increased rates for many months postinjury. While comorbid conditions are significant, they do not account for the differences in outcomes. This study contributes to informing research efforts on better quantifying the attributable burden of hospitalised injury-related disability and mortality in Australia.

Original language	English
Article number	e013266
Pages (from-to)	1-9
Number of pages	9
Journal	BMJ Open
Volume	6
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2016-013266
Publication status	Published - 7 Dec 2016

Bibliographical note

Copyright the Author(s) 2016. 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

comorbidity
health service use
hospitalisation
injury
mortality

Access to Document

10.1136/bmjopen-2016-013266

Publisher version (open access).pdfFinal published version, 1.04 MB

Cite this

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title = "Quantifying the hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia",

abstract = "Objectives To quantify the 12-month hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia. Setting: New South Wales, Queensland and South Australia, Australia. Participants: Individuals ≥18years who had an injury-related hospital admission in 2009 formed the injured cohort. The non-injured comparison cohort was randomly selected from the electoral roll and was matched 1:1 on age, gender and postcode of residence at the date of the index injury admission of their matched counterpart. Primary outcome measures: Using linked emergency department presentation, hospital admission and mortality records from 1 January 2008 to 31 December 2010 for both the injured and non-injured cohorts, 12-month mortality and pre-index and post-index injury hospital service use was examined. Adjusted rate ratios and attributable risk were calculated. Results: There were 167600 individuals injured in 2009 and admitted to hospital in New South Wales, South Australia or Queensland with a matched comparison. The injured cohort had 3 times higher proportion of having ≥1 comorbidity preinjury, higher preinjury hospital service use, and a higher 12-month mortality compared with a non-injured comparison group. The injured cohort had 2.20 (95% CI 2.12 to 2.28) times higher rate of hospital admissions in the 12months post the index injury admission compared with the non-injured comparison cohort. Injury was a likely contributory factor in at least 55% of hospitalisations within 12months of the index injury hospitalisation. Conclusions: Individuals who had an injury-related hospitalisation had higher mortality and are hospitalised at increased rates for many months postinjury. While comorbid conditions are significant, they do not account for the differences in outcomes. This study contributes to informing research efforts on better quantifying the attributable burden of hospitalised injury-related disability and mortality in Australia.",

keywords = "comorbidity, health service use, hospitalisation, injury, mortality",

author = "Mitchell, {Rebecca J.} and Cameron, {Cate M.} and Rod Mcclure",

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AU - Mitchell, Rebecca J.

AU - Cameron, Cate M.

AU - Mcclure, Rod

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PY - 2016/12/7

Y1 - 2016/12/7

N2 - Objectives To quantify the 12-month hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia. Setting: New South Wales, Queensland and South Australia, Australia. Participants: Individuals ≥18years who had an injury-related hospital admission in 2009 formed the injured cohort. The non-injured comparison cohort was randomly selected from the electoral roll and was matched 1:1 on age, gender and postcode of residence at the date of the index injury admission of their matched counterpart. Primary outcome measures: Using linked emergency department presentation, hospital admission and mortality records from 1 January 2008 to 31 December 2010 for both the injured and non-injured cohorts, 12-month mortality and pre-index and post-index injury hospital service use was examined. Adjusted rate ratios and attributable risk were calculated. Results: There were 167600 individuals injured in 2009 and admitted to hospital in New South Wales, South Australia or Queensland with a matched comparison. The injured cohort had 3 times higher proportion of having ≥1 comorbidity preinjury, higher preinjury hospital service use, and a higher 12-month mortality compared with a non-injured comparison group. The injured cohort had 2.20 (95% CI 2.12 to 2.28) times higher rate of hospital admissions in the 12months post the index injury admission compared with the non-injured comparison cohort. Injury was a likely contributory factor in at least 55% of hospitalisations within 12months of the index injury hospitalisation. Conclusions: Individuals who had an injury-related hospitalisation had higher mortality and are hospitalised at increased rates for many months postinjury. While comorbid conditions are significant, they do not account for the differences in outcomes. This study contributes to informing research efforts on better quantifying the attributable burden of hospitalised injury-related disability and mortality in Australia.

AB - Objectives To quantify the 12-month hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia. Setting: New South Wales, Queensland and South Australia, Australia. Participants: Individuals ≥18years who had an injury-related hospital admission in 2009 formed the injured cohort. The non-injured comparison cohort was randomly selected from the electoral roll and was matched 1:1 on age, gender and postcode of residence at the date of the index injury admission of their matched counterpart. Primary outcome measures: Using linked emergency department presentation, hospital admission and mortality records from 1 January 2008 to 31 December 2010 for both the injured and non-injured cohorts, 12-month mortality and pre-index and post-index injury hospital service use was examined. Adjusted rate ratios and attributable risk were calculated. Results: There were 167600 individuals injured in 2009 and admitted to hospital in New South Wales, South Australia or Queensland with a matched comparison. The injured cohort had 3 times higher proportion of having ≥1 comorbidity preinjury, higher preinjury hospital service use, and a higher 12-month mortality compared with a non-injured comparison group. The injured cohort had 2.20 (95% CI 2.12 to 2.28) times higher rate of hospital admissions in the 12months post the index injury admission compared with the non-injured comparison cohort. Injury was a likely contributory factor in at least 55% of hospitalisations within 12months of the index injury hospitalisation. Conclusions: Individuals who had an injury-related hospitalisation had higher mortality and are hospitalised at increased rates for many months postinjury. While comorbid conditions are significant, they do not account for the differences in outcomes. This study contributes to informing research efforts on better quantifying the attributable burden of hospitalised injury-related disability and mortality in Australia.

KW - comorbidity

KW - health service use

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KW - injury

KW - mortality

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DO - 10.1136/bmjopen-2016-013266

M3 - Article

C2 - 27927664

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VL - 6

SP - 1

EP - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 12

M1 - e013266

ER -

Quantifying the hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Burden and cost of injury-attributable health care use and mortality in Australia

Cite this

Quantifying the hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Projects

Burden and cost of injury-attributable health care use and mortality in Australia

Cite this