title: Severity of disability related to road traffic crashes in the Spanish adult population.
abstract: BACKGROUND
  The severity of disability related to road traffic crashes has been little studied, despite the significant health and socio-economic impacts that determine victims' quality of life.
  
  
  OBJECTIVE
  To estimate the consequences of road traffic crashes on the severity of disability, in terms of individuals' capacity to execute activities and perform tasks in their current environment, using aids.
  
  
  METHODS
  Cross-sectional study conducted on community-dwelling participants in the "2008 National Survey of Disability", with data on 91,846 households having 20,425 disabled persons, 443 of whom had disability due to road traffic crashes. We measured severity using two indicators, i.e., the Capacity (CSI) and Performance (PSI) Severity Indices.
  
  
  RESULTS
  The highest proportion of disability was mild (CSI=70.5%; PSI=80.8%), while 7.6% (CSI) and 4.9% (PSI) was severe/complete respectively. The moderate/severe disability rate was 0.6 per thousand on the CSI, decreasing to 0.4 per thousand on the PSI. No differences were observed by age or sex. Moderate/severely disabled persons had a fourfold higher probability of being retired or unfit for work. Mental and nervous system impairments were more closely related to moderate/severe/complete problems of capacity and performance (p<0.001), disability for carrying out general tasks and demands, and interpersonal interactions and relationships (p<0.001). Being permanently bedridden (p<0.001), receiving aids (p<0.001), family support (p<0.05) and moving home (p<0.05) increased with an increase in the level of severity.
  
  
  CONCLUSIONS
  Road traffic crashes mainly cause mild disability. Moderate/severe disability is associated with lower work capacity, greater functional dependence, and increased need of aids, moving home and family support.
authors.affiliation: Department of Epidemiological Analysis and Health Situation, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain. Electronic address: p_rocio_del_pilar@hotmail.com.
authors.forename: Rocío
authors.initials: R
authors.lastname: Palmera-Suárez
authors.affiliation: Department of Epidemiological Analysis and Health Situation, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Department of Preventive Medicine and Public Health. School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029 Madrid, Spain. Electronic address: teresalc@isciii.es.
authors.forename: Teresa
authors.initials: T
authors.lastname: López-Cuadrado
authors.affiliation: Department of Statistics, Ludwig-Maximilians-Universität, Ludwigstraße 33, PC 80539 Munich, Germany. Electronic address: sarah.brockhaus@stat.uni-muenchen.de.
authors.forename: Sarah
authors.initials: S
authors.lastname: Brockhaus
authors.affiliation: Department of Epidemiological Analysis and Health Situation, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain. Electronic address: rfcuenca@isciii.es.
authors.forename: Rafael
authors.initials: R
authors.lastname: Fernández-Cuenca
authors.affiliation: Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain. Electronic address: ealcalde@isciii.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Alcalde-Cabero
authors.affiliation: Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Department of Preventive Medicine and Public Health. School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029 Madrid, Spain. Electronic address: igalan@isciii.es.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Galán
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D013030:Spain; D055815:Young Adult
keywords: Disability; Impairments; Road traffic crashes; Severity indices