title: Prognostic indicators of social outcomes in persons who sustained an injury in a road traffic crash.
abstract: BACKGROUND
  There is a lack of longitudinal studies with adequate sample size and follow-up period which have objectively assessed social outcomes among those with mild or moderate musculoskeletal injury or that are not limited to hospital inpatients. We aimed to address this gap by prospectively assessing the potential predictors of return to pre-injury work and daily activities.
  
  
  METHODS
  Persons with mild/moderate musculoskeletal injuries from a vehicle-related crash were surveyed within the first 3 months after the crash (baseline; n=364), and at 12 (n=284) and 24 months (n=252). Participants self-reported return to work, and whether it was return to full or modified duties at work. Analyses were restricted to 170 participants who reported being in pre-injury paid work and had provided information at either 12 months only or at both 12 and 24 months. Return to usual activities was assessed using the European Quality of Life-5 Dimensions (EQ-5D) scale 'Usual Activities' dimension.
  
  
  RESULTS
  Twenty-four months after injury 82% (n=121) had returned to work. After multivariable adjustment, not being admitted to hospital was associated with 44% higher likelihood of returning to work at 24 months. Not having any pre-injury chronic illness was associated with returning to work after 24 months, multivariable-adjusted risk ratio (RR), 1.21 (95% confidence intervals, CI: 1.02-1.45). Each 1-SD increase in Medical Outcomes Survey Short Form-12 Mental Component Summary (SF-12 MCS) score at baseline was associated with returning to work at 24 months RR 1.13 (95% CI: 1.02-1.25). Younger age, higher SF-12 physical component summary (PCS), and EQ-5D visual analogue scale (VAS) scores were mutually independent predictors of returning to usual activities 24 months later.
  
  
  CONCLUSIONS
  A range of bio-psychosocial factors, particularly quality of life measures, independently predicted social outcomes including return to work and return to usual daily activities. These determinants could be measured early in the recovery process and be potentially amenable to intervention.
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Australia. Electronic address: bamini.gopinath@sydney.edu.au.
authors.forename: Bamini
authors.initials: B
authors.lastname: Gopinath
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Australia.
authors.forename: Jagnoor
authors.initials: J
authors.lastname: Jagnoor
authors.affiliation: Ingham Institute for Applied Medical Research, University of New South Wales, Australia.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Harris
authors.affiliation: Pain Management Research Institute, Sydney Medical School, University of Sydney, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Nicholas
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Australia.
authors.forename: Petrina
authors.initials: P
authors.lastname: Casey
authors.affiliation: Pain Management Research Institute, Sydney Medical School, University of Sydney, Australia; School of Public Health, University of Sydney, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.affiliation: George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
authors.forename: Christropher G
authors.initials: CG
authors.lastname: Maher
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Australia.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology* / Q000706:statistics & numerical data; D000328:Adult; D035881:Compensation and Redress / Q000331:legislation & jurisprudence; D004185:Disability Evaluation; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D062707:Return to Work; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*
keywords: Cohort study; Musculoskeletal injury; Quality of life; Return to work; Road traffic crash; Usual activities