Anna Devlin1, Ben Beck2, Pam M Simpson3, Christina L Ekegren4, Melita J Giummarra5, Elton R Edwards6, Peter A Cameron7, Susan Liew8, Andrew Oppy9, Martin Richardson10, Richard Page11, Belinda J Gabbe12. 1. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. Electronic address: Anna.Devlin@monash.edu. 2. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. Electronic address: Ben.Beck@monash.edu. 3. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. Electronic address: Pamela.Simpson@monash.edu. 4. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. Electronic address: Christina.Ekegren@monash.edu. 5. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, 260 Kooyong Road, Caulfield, VIC, 3162, Australia. Electronic address: Melita.Giummarra@monash.edu. 6. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia; Department of Orthopaedic Surgery, The Alfred Hospital, Melbourne, Australia. Electronic address: ere@bigpond.net.au. 7. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia; Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Australia. Electronic address: Peter.cameron@monash.edu. 8. Department of Orthopaedic Surgery, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia. Electronic address: s.liew@alfred.org.au. 9. Department of Trauma and Orthopaedic Surgery, The Royal Melbourne Hospital, Melbourne, Australia. Electronic address: Andrew.Oppy@mh.org.au. 10. Department Surgery, Epworth Clinical school, University of Melbourne, Melbourne, Australia. Electronic address: orthovic@gmail.com. 11. Barwon Centre for Orthopaedic Research and Education, Barwon Health and St John of God Hospital Geelong, 80 Myers St, Geelong 3220, Australia; School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds 3216, Australia. Electronic address: richard.page@deakin.edu.au. 12. School of Public Health and Preventive Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, 553 St Kilda Road, Melbourne, VIC, 3004, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park Swansea, United Kingdom. Electronic address: Belinda.Gabbe@monash.edu.
Abstract
BACKGROUND: Pedestrians, cyclists and motorcyclists are vulnerable to serious injury due to limited external protective devices. Understanding the level of recovery, and differences between these road user groups, is an important step towards improved understanding of the burden of road trauma, and prioritisation of prevention efforts. This study aimed to characterise and describe patient-reported outcomes of vulnerable road users at 6 and 12 months following orthopaedic trauma. METHODS: A registry-based cohort study was conducted using data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) and included pedestrians, cyclists and motorcyclists who were hospitalised for an orthopaedic injury following an on-road collision that occurred between January 2009 and December 2016. Outcomes were measured using the 3-level EuroQol 5 dimensions questionnaire (EQ-5D-3 L), Glasgow Outcome Scale - Extended (GOS-E) and return to work questions. Outcomes were collected at 6 and 12 months post-injury. Multivariable generalized estimating equations (GEE), adjusted for confounders, were used to compare outcomes between the road user groups over time. RESULTS: 6186 orthopaedic trauma patients met the inclusion criteria during the 8-year period. Most patients were motorcyclists (42.8%) followed by cyclists (32.6%) and pedestrians (24.6%). Problems were most prevalent on the usual activities item of the EQ-5D-3 L at 6-months post-injury, and the pain/discomfort item of the EQ-5D-3 L at 12 months. The adjusted odds of reporting problems on all EQ-5D-3 L items were lower for cyclists when compared to pedestrians. Moreover, an average cyclist had a greater odds of a good recovery on the GOS-E, (AOR 2.75, 95% CI 2.33, 3.25) and a greater odds of returning to work (AOR = 3.13, 95% CI 2.46, 3.99) compared to an average pedestrian. CONCLUSION: Pedestrians and motorcyclists involved in on-road collisions experienced poorer patient-reported outcomes at 6 and 12 months post-injury when compared to cyclists. A focus on both primary injury prevention strategies, and investment in ongoing support and treatment to maximise recovery, is necessary to reduce the burden of road trauma for vulnerable road users.
BACKGROUND: Pedestrians, cyclists and motorcyclists are vulnerable to serious injury due to limited external protective devices. Understanding the level of recovery, and differences between these road user groups, is an important step towards improved understanding of the burden of road trauma, and prioritisation of prevention efforts. This study aimed to characterise and describe patient-reported outcomes of vulnerable road users at 6 and 12 months following orthopaedic trauma. METHODS: A registry-based cohort study was conducted using data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) and included pedestrians, cyclists and motorcyclists who were hospitalised for an orthopaedic injury following an on-road collision that occurred between January 2009 and December 2016. Outcomes were measured using the 3-level EuroQol 5 dimensions questionnaire (EQ-5D-3 L), Glasgow Outcome Scale - Extended (GOS-E) and return to work questions. Outcomes were collected at 6 and 12 months post-injury. Multivariable generalized estimating equations (GEE), adjusted for confounders, were used to compare outcomes between the road user groups over time. RESULTS: 6186 orthopaedic traumapatients met the inclusion criteria during the 8-year period. Most patients were motorcyclists (42.8%) followed by cyclists (32.6%) and pedestrians (24.6%). Problems were most prevalent on the usual activities item of the EQ-5D-3 L at 6-months post-injury, and the pain/discomfort item of the EQ-5D-3 L at 12 months. The adjusted odds of reporting problems on all EQ-5D-3 L items were lower for cyclists when compared to pedestrians. Moreover, an average cyclist had a greater odds of a good recovery on the GOS-E, (AOR 2.75, 95% CI 2.33, 3.25) and a greater odds of returning to work (AOR = 3.13, 95% CI 2.46, 3.99) compared to an average pedestrian. CONCLUSION: Pedestrians and motorcyclists involved in on-road collisions experienced poorer patient-reported outcomes at 6 and 12 months post-injury when compared to cyclists. A focus on both primary injury prevention strategies, and investment in ongoing support and treatment to maximise recovery, is necessary to reduce the burden of road trauma for vulnerable road users.
Authors: Joanna F Dipnall; Richard Page; Lan Du; Matthew Costa; Ronan A Lyons; Peter Cameron; Richard de Steiger; Raphael Hau; Andrew Bucknill; Andrew Oppy; Elton Edwards; Dinesh Varma; Myong Chol Jung; Belinda J Gabbe Journal: PLoS One Date: 2021-09-23 Impact factor: 3.240
Authors: Lisa N Sharwood; Annette Kifley; Ashley Craig; Bamini Gopinath; Jagnoor Jagnoor; Ian D Cameron Journal: BMC Public Health Date: 2021-11-02 Impact factor: 3.295