title: Prevalence and predictors of disability 24-months after injury for hospitalised and non-hospitalised participants: results from a longitudinal cohort study in New Zealand.
abstract: BACKGROUND
  Most studies investigating disability outcomes following injury have examined hospitalised patients. It is not known whether variables associated with disability outcomes are similar for injured people who are not hospitalised.
  
  
  OBJECTIVE
  This paper compares the prevalence of disability 24 months after injury for participants in the Prospective Outcomes of Injury Study who were hospitalised and those non-hospitalised, and also seeks to identify pre-injury and injury-related predictors of disability among hospitalised and non-hospitalised participants.
  
  
  METHODS
  Participants, aged 18-64 years, were recruited from an injury claims register managed by New Zealand's no-fault injury compensation insurer after referral by health care professionals. A wide range of pre-injury socio-demographic, health and psychosocial characteristics were collected, as well as injury-related characteristics; outcome is assessed using the WHODAS. Multivariable models estimating relative risks of disability for hospitalised and non-hospitalised participants were developed using Poisson regression methods.
  
  
  RESULTS
  Of 2856 participants, analyses were restricted to 2184 (76%) participants for whom both pre-injury and 24 month WHODAS data were available. Of these, 25% were hospitalised. In both hospitalised and non-hospitalised groups, 13% experience disability (WHODAS≥10) 24 months after injury; higher than pre-injury (5%). Of 28 predictor variables, seven independently placed injured participants in the hospitalised group at increased risk of disability 24 months after injury; eight in the non-hospitalised. Only four predictors (pre-injury disability, two or more pre-injury chronic conditions, pre-injury BMI≥30 and trouble accessing healthcare services) were common to both the hospitalised and non-hospitalised groups. There is some evidence to suggest that among the hospitalised group, Māori have higher risk of disability relative to non-Māori.
  
  
  CONCLUSIONS
  At 24 months considerable disability is borne, equally, by hospitalised and non-hospitalised groups. However, predictors of disability are not necessarily consistent between the hospitalised and non-hospitalised groups, suggesting caution in generalising results from one group to the other.
authors.affiliation: Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand ; School of Health and Social Services, College of Health, Massey University, Palmerston North, New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Derrett
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wilson
authors.forename: Ari
authors.initials: A
authors.lastname: Samaranayaka
authors.forename: John
authors.initials: J
authors.lastname: Langley
authors.forename: Emma
authors.initials: E
authors.lastname: Wyeth
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
authors.forename: Rebbecca
authors.initials: R
authors.lastname: Lilley
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Davie
authors.forename: Melbourne
authors.initials: M
authors.lastname: Mauiliu
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007345:Insurance Claim Review; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D014947:Wounds and Injuries / Q000453:epidemiology / Q000503:physiopathology*; D055815:Young Adult