Disability and quality of life after a road traffic accident in Medellin. Cohort study
DOI:
https://doi.org/10.17533/udea.rfnsp.e347015Keywords:
traffic accidents, functioning, quality of life, pain, depression, Medellín (Colombia).Abstract
Objective: To compare functioning, quality of life (QoL), pain, and depression at one year between adults under and over 60 years of age who had moderate and severe injuries in traffic accidents in Medellin and its metropolitan area.
Methods: Secondary analysis of two cohorts of patients with moderate and severe injuries that occurred in Medellín and its metropolitan area in 2009-2010 and 2015-2016. They were evaluated at baseline and 12 months with functioning (who-das ii), QoL (sf-36), pain (vas), and depression (phq-9). The differences between cohorts 12 months after the accident were compared with t-Student test. A multiple linear regression analysis was done to determine factors related to disability and QoL.
Results: 837 patients were included, 84,8% completed the follow-up. The motorcycle was the main vehicle involved (86,1% vs. 60,7). Better functioning was observed in people over 60 years of age in personal care, and greater commitment in activities of daily living, work and global functioning. QoL was significantly better in minors, in emotional performance, physical performance and physical function. In the multivariate analysis, the greater compromise in functioning was explained by being female, older, more severe injury, greater pain, and depression. The best QoL was explained by being male, younger, less severe injury, pain, and depressive symptoms.
Conclusions: Age, sex, injury severity, pain, and depression explain disability and QoL dimensions 12 months after the traffic accident
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References
World Health Organization. Global status report on road safety 2018. World Health Organization [internet]; 2019 [citado 2019, feb. 9]. Disponible en: https://www.who.int/violence_injury_prevention/road_safety_status/2018/en/
Organización Mundial de la Salud. Traumatismos causados por el tránsito. [internet]; 2022 [citado 2022 sep. 21]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/road-traffic-injuries
Agencia Nacional de Seguridad Vial. Observatorio. Estadísticas [internet]; 2009 [citado 2021 jul. 8]. https://ansv.gov.co/es/observatorio/estad%C3%ADsticas/historico-victimas
Secretaría de Movilidad de Medellín. Visión cero [internet]; 2021 [citado 2021 ago. 7]. Disponible en: htpp://visiónceromedellín.co/
Lugo LH, García HI, Cano BC, et al. Multicentric study of epidemiological and clinical characteristics of persons injured in motor vehicle accidents in Medellín, Colombia, 2009-2010. Colomb Med. [internet]. 2013 [citado 2021 ago. 7]; 44(2):100-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4002028/
Lugo LH, Salinas F, Cano BC, et al. Calidad de vida y reinserción al trabajo en pacientes con trauma moderado y grave por accidentes de tránsito en Medellín (Colombia). Rev. Gerenc. Polít. Salud. 2015; 14(28):88-96. DOI: https://doi.org/10.11144/Javeriana.rgyps18-28.cvrt
Soberg HL, Bautz E, et al. Long-term multidimensional functional consequences of severe multiple injuries two years after trauma: A prospective longitudinal cohort study. J Trauma Inj Infect Crit Care. 2007;62(2):461-70. DOI: https://doi.org/10.1097/01.ta.0000222916.30253.ea
Rissanen R, Berg H-Y, Hasselberg M. Quality of life following road traffic injury: A systematic literature review. Accid Anal Prev. 2017;108:308-20. DOI: https://doi.org/10.1016/j.aap.2017.09.013
World Health Organization. How to use the ICF: A practical manual for using the International Classification of Functioning, Disability and Health (ICF). Exposure draft for comment. Geneva: WHO [internet]; 2013 [citado 2022 jul. 21]. Disponible en: https://cdn.who.int/media/docs/default-source/classification/icf/drafticfpracticalmanual2.pdf?sfvrsn=8a214b01_4&download=true
World Health Organization. WHOQOL Measuring Quality of Life [interneet]. 2012 [citado 2022 jul. 21]. Disponible en: https://www.who.int/tools/whoqol
Brown K, Cameron ID, Keay L, et al. Functioning and health-related quality of life following injury in older people: A systematic review. Inj Prev 2017;23(6):403-11. DOI: https://doi.org/10.1136/injuryprev-2016-042192
Seijas-Bermúdez V, Payares-Álvarez K, Cano-Restrepo B, et al. Lesiones graves y moderadas por accidentes de tránsito en mayores de 60 años. Medellín, Colombia. Rev. Fac. Med. 2019; 67(2):459-62. DOI: https://doi.org/10.15446/revfacmed.v67n2.69549
Colombia, Congreso de la República. Ley estatutaria 1581, por la cual se dictan disposiciones generales para la protección de datos peronales [internet] (2012, oct. 17). [citado 2022 jul. 21]. Disponible en: https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=49981
Colombia, Ministerio de Salud. Resolución 8430, por lo cual se estrablecen las normas cient´rífcias, técnicas y administrativas para la investigación en salud [internet] (1993, oct. 4) [citado 2022 jul. 21]. Disponible en: minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF
The World Medical Association. Declaration of Helsinki. Ethical principles for medical research involving human subjects [internet]; 2000 [citado 2022 jul. 21]. Disponible en: https://www.wma.net/wp-content/uploads/2016/11/DoH-Oct2008.pdf
Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma. 1997;43(6):922-5. DOI: https://doi.org/10.1097/00005373-199712000-00009
Federici S, Bracalenti M, Meloni F, Luciano J V. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil. 2017;39(23):2347-80. DOI: https://doi.org/10.1080/09638288.2016.1223177
Lugo LH, García HI, Gómez C. Confiabilidad del cuestionario de calidad de vida en salud SF-36 en Medellín, Colombia. Rev. Fac. Nac. Salud Pública. 2006;24(2):37-50. Vol. 24 Núm. 2 (2006c https://revistas.udea.edu.co/index.php/fnsp/article/view/243
Cassiani CA, Vargas C, Pérez E, et al. Confiabilidad y dimensión del cuestionario de salud del paciente (PHQ-9) para la detección de síntomas de depresión en estudiantes de ciencias de la salud en Cartagena, 2014. Biomédica. 2017;3737(11):112-20. DOI: https://doi.org/10.7705/biomedica.v37i0.3221
Boonstra AM, Schiphorst Preuper HR, et al. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545-50. DOI: https://doi.org/10.1016/j.pain.2014.09.014
Húzgame Á. SIRAS: primer año de una herramienta contundente para la seguridad vial en Colombia. Fasecolda [internet]. 2017 [citado 2022 jul. 21]; (169):28-31. Disponible en: https://revista.fasecolda.com/index.php/revfasecolda/article/view/405/393
Stewart BT, Yankson IK, Afukaar F, et al. Road traffic and other unintentional injuries among travelers to developing countries. Med Clin North Am. 2016;100(2):331-43. DOI: https://doi.org/10.1016/j.mcna.2015.07.011
Espinosa López A, Cabrera Arana G, Velásquez Osorio N. Epidemiología de incidentes viales en Medellín-Colombia, 2010-2015. Rev. Fac. Nac. Salud Pública. 2017;35(1):7-15. DOI: https://doi.org/10.17533/udea.rfnsp.v35n1a02
Wang T, Wang Y, Xu T, et al. Epidemiological and clinical characteristics of 3327 cases of traffic trauma deaths in Beijing from 2008 to 2017: A retrospective analysis. Medicine 2020;99:1(e18567). DOI: https://doi.org/10.1097/MD.0000000000018567
Leel HH, Cho JS, Lim YS, et al. Relationship between age and injury severity in traffic accidents involving elderly pedestrians. Clin Exp Emerg Med. 2019;6(3):235-41. DOI: https://doi.org/10.15441/ceem.18.052
Soberg HL, Finset A, et al. The trajectory of physical and mental health from injury to 5 years after multiple trauma: A prospective, longitudinal cohort study. Arch Phys Med Rehabil. 2012;93(5):765-74. DOI: https://doi.org/10.1016/j.apmr.2011.08.050
Andersen D, Ryb G, Dischinger P, et al. Self-reported health indicators in the year following a motor vehicle crash: A comparison of younger versus older subjects. Ann Adv Automot Med. [internet]. 2010 [citado 2022 jul. 21]; 54:359-67. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242549/
Gopinath B, Harris IA, Nicholas M, et al. A comparison of health outcomes in older versus younger adults following a road traffic crash injury: A cohort study. PLoS One. 2015;10(4):1-11. DOI: https://doi.org/10.1371/journal.pone.0122732
Tan AL, Chiong Y, Nadkarni N, et al. Predictors of change in functional outcome at six months and twelve months after severe injury: A retrospective cohort study. World J Emerg Surg. 2018;13:57. https://doi.org/10.1186/s13017-018-0217-y
Bhasin S, Gill T, Reuben DB, et al. Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE): A cluster-randomized pragmatic trial of a multifactorial fall injury prevention strategy: Design and methods. J. Gerontol. 2018;73(8):1053-61. DOI: https://doi.org/10.1093/gerona/glx190
Lugo-Agudelo LH, Castro-García PA, Mejía-Mejía Aurelio, et al. Determinantes de los costos de la atención y la rehabilitación de personas lesionadas en accidentes de tránsito en Medellín, Colombia. Rev. Gerenc. Polít. Salud. 2016;15(31):176-89. https://doi.org/10.11144/Javeriana.rgyps15-31.dcar
Kenardy J, Heron M, Warren J, Brown E. The effect of mental health on long-term health-related quality of life following a road traffic crash: Results from the UQ SuPPORT study. Injury. 2015;46(5):883-90. DOI: https://doi.org/10.1016/j.injury.2014.11.006
Agencia Nacional de Seguridad Vial. Informe sobre seguridad vial para el Congreso de la Republica. [internet] 2021 jun. [citado 2022 sep. 21]. https://ansv.gov.co/sites/default/files/Documentos/Observatorio/Informe_al_Congreso_ANSV_2020.pdf
Naciones Unidas. Foro Político de Alto Nivel sobre Desarrollo Sostenible [internet]; 2012 [citado 2022 jul. 21]. Disponible en: https://www.unodc.org/unodc/es/commissions/SDG/high-level-political-forum.html
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