Trajectories of sickness absence after road traffic injury: a Swedish register-based cohort study

ObjectivesDespite much focus on the health impact of road traffic injury (RTI) on life, there is a lack of knowledge of the dynamic process of return to work following RTI and its related factors. The aim of this study was to identify longitudinal patterns of sickness absence (SA) following RTI, to examine the patterns’ interplay with health-related quality of life (HRQoL) and to determine if there are differences, regarding the patterns and interplay, according to injury severity.DesignA register-based prospective cohort study.SettingAdministrative data on RTI in Sweden from the Swedish Traffic Accident Data Acquisition System (STRADA) and Swedish Social Insurance data.ParticipantsIndividuals suffering an RTI (total n=4761) were identified in STRADA between 1 January 2007 and 31 December 2009. A total of 903 of these met the inclusion criteria for the current study and were included.Primary and secondary outcome measuresThe primary outcome measure was SA following RTI. The secondary outcome measure was HRQoL.ResultsThree distinct patterns of SA were identified; ‘Stable’, ‘Quick decrease’ and ‘Gradual decrease’. The patterns differed in the number of initial SA days and the rate of reduction of SA days. After 3 years, all three patterns had almost the same level of SA. Higher injury severity and a higher number of SA days had a negative interplay with HRQoL. Participants who initially had a higher number of SA days were more likely to report a low HRQoL, indicating that people with a slower return to work are more vulnerable.ConclusionThe study highlights the heterogeneity of return to work after an RTI. People with a more severe injury and slower pace of return to work seem to be more vulnerable with regards to HRQoL loss following RTI.

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Association between perception of fault for the crash and function, return to work and health status 1 year after road traffic injury: a registry-based cohort study

BMJ Open ◽

10.1136/bmjopen-2015-009907 ◽

2015 ◽

Vol 5 (11) ◽

pp. e009907 ◽

Cited By ~ 14

Author(s):

Belinda J Gabbe ◽

Pamela M Simpson ◽

Peter A Cameron ◽

Christina L Ekegren ◽

Elton R Edwards ◽

...

Keyword(s):

Cohort Study ◽

Health Status ◽

Return To Work ◽

Road Traffic ◽

Road Traffic Injury ◽

Traffic Injury ◽

And Function ◽

Work And Health

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Determining universal processes related to best outcome in emergency abdominal surgery: a multicentre, international, prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2014-006239 ◽

2014 ◽

Vol 4 (10) ◽

pp. e006239 ◽

Cited By ~ 7

Author(s):

Aneel Bhangu ◽

J Edward Fitzgerald ◽

Stuart Fergusson ◽

Chetan Khatri ◽

Hampus Holmer ◽

...

Keyword(s):

Cohort Study ◽

Abdominal Surgery ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Outcome Measure ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Perioperative Mortality ◽

Acute Surgery ◽

Emergency Abdominal Surgery

IntroductionEmergency abdominal surgery outcomes represent an internationally important marker of healthcare quality and capacity. In this study, a novel approach to investigating global surgical outcomes is proposed, involving collaborative methodology using ‘snapshot’ clinical data collection over a 2-week period. The primary aim is to identify internationally relevant, modifiable surgical practices (in terms of modifiable process, equipment and clinical management) associated with best care for emergency abdominal surgery.Methods and analysisThis is a multicentre, international, prospective cohort study. Any hospital in the world performing acute surgery can participate, and any patient undergoing emergency intraperitoneal surgery is eligible to enter the study. Centres will collect observational data on patients for a 14-day period during a 5-month window and required data points will be limited to ensure practicality for collaborators collecting data. The primary outcome measure is the 24 h perioperative mortality, with 30-day perioperative mortality as a secondary outcome measure. During registration, participants will undertake a survey of available resources and capacity based on the WHO Tool for Situational Analysis.Ethics and disseminationThe study will not affect clinical care and has therefore been classified as an audit by the South East Scotland Research Ethics Service in Edinburgh, Scotland. Baseline outcome measurement in relation to emergency abdominal surgery has not yet been undertaken at an international level and will provide a useful indicator of surgical capacity and the modifiable factors that influence this. This novel methodological approach will facilitate delivery of a multicentre study at a global level, in addition to building international audit and research capacity.Trial registration numberThe study has been registered with ClinicalTrials.gov (Identifier: NCT02179112).

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Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study

Journal of Neonatal Surgery ◽

10.47338/jns.v11.1029 ◽

2022 ◽

Vol 11 ◽

pp. 3

Author(s):

Hyginus Okechukwu Ekwunife ◽

Emmanuel Ameh ◽

Lukman Abdur-Rahman ◽

Adesoji Ademuyiwa ◽

Emem Akpanudo ◽

...

Keyword(s):

Cohort Study ◽

Surgical Site Infection ◽

Postoperative Complication ◽

Outcome Measure ◽

Postoperative Mortality ◽

Sub Saharan Africa ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Complication Rates ◽

Site Infection

Background: Despite a decreasing global neonatal mortality, the rate in sub-Saharan Africa is still high. The contribution and the burden of surgical illness to this high mortality rate have not been fully ascertained. This study is performed to determine the overall and disease-specific mortality and morbidity rates following neonatal surgeries; and the pre, intra, and post-operative factors affecting these outcomes. Methods: This was a prospective observational cohort study; a country-wide, multi-center observational study of neonatal surgeries in 17 tertiary hospitals in Nigeria. The participants were 304 neonates that had surgery within 28 days of life. The primary outcome measure was 30-day postoperative mortality and the secondary outcome measure was 30-day postoperative complication rates. Results: There were 200 (65.8%) boys and 104 (34.2%) girls, aged 1-28 days (mean of 12.1 ± 10.1 days) and 99(31.6%) were preterm. Sepsis was the most frequent major postoperative complication occurring in 97(32%) neonates. Others were surgical site infection (88, 29.2%) and malnutrition (76, 25.2%). Mortality occurred in 81 (26.6%) neonates. Case-specific mortalities were: gastroschisis (14, 58.3%), esophageal atresia (13, 56.5%) and intestinal atresia (25, 37.2%). Complications significantly correlated with 30-day mortality (p <0.05). The major risk predictors of mortality were apnea (OR=10.8), severe malnutrition (OR =6.9), sepsis (OR =7. I), deep surgical site infection (OR=3.5), and re-operation (OR=2.9). Conclusion: Neonatal surgical mortality is high at 26.2%. Significant mortality risk factors include prematurity, apnea, malnutrition, and sepsis.

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Health and return to work in the first two years following road traffic injury: a comparison of outcomes between compensation claimants in Victoria and New South Wales, Australia

Injury ◽

10.1016/j.injury.2020.07.002 ◽

2020 ◽

Vol 51 (10) ◽

pp. 2199-2208

Author(s):

Melita J Giummarra ◽

Darnel Murgatroyd ◽

Yvonne Tran ◽

Sam Adie ◽

Rajat Mittal ◽

...

Keyword(s):

Return To Work ◽

Road Traffic ◽

New South ◽

New South Wales ◽

Road Traffic Injury ◽

Traffic Injury ◽

South Wales

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A Comparison of Ordered and Unordered Response Models for Analyzing Road Traffic Injury Severities in the North-Eastern Turkey

Periodica Polytechnica Transportation Engineering ◽

10.3311/pptr.8782 ◽

2017 ◽

Vol 45 (3) ◽

pp. 119

Author(s):

Ali Kemal Çelik ◽

Erkan Oktay

Keyword(s):

Risk Factors ◽

Road Safety ◽

Injury Severity ◽

Road Traffic ◽

Road Traffic Injury ◽

Response Models ◽

Traffic Injury ◽

Eastern Turkey ◽

North Eastern ◽

Injury Severities

Road traffic injuries are estimated to be one of the major causes of death worldwide and a majority of them occur in low- and middle income countries. In that respect, further studies that address to determine risk factors that may influence road traffic injury severities in the corresponding countries may contribute the existing road safety literature. This paper determines possible risk factors influencing road traffic injury severity in north-eastern Turkey. For this purpose, a retrospective cross-sectional study is conducted analysing 11,771 traffic accidents reported by the police during the sample period of 2008-2013. As the accident severity is inherently ordered, the data are analysed using both ordered and unordered response models. The estimation results reveal that several driver (age and education level), accident (speeding violation, avoiding manoeuvre and right-of-way rule), vehicle (bus/minivan, single-unit truck/heavy truck, private and single vehicles), temporal (time of day, morning peak, evening peak), environmental (summer and cloudy or rainy weather), geometry (asphalt road and road class type), and control characteristics (presence of crosswalk and traffic lights) were found to have an impact on injury severity. This paper is most probably the first attempt to analyse possible risk factors of road traffic injury severities in Turkey using both ordered and unordered response models. The evidence of this study may be valuable for future road safety policies in emerging countries.

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O4 Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

BJS Open ◽

10.1093/bjsopen/zrab033.003 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

◽

Samuel Lawday ◽

Isobel Trout

Keyword(s):

Cohort Study ◽

Outcome Measure ◽

Elective Surgery ◽

Postoperative Mortality ◽

Postoperative Recovery ◽

Pulmonary Complications ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Complication Rates ◽

The Impact

Abstract Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery is poorly understood. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality. The secondary outcome measure was pulmonary complications (pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation). Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p < 0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p < 0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p < 0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p = 0·046), emergency versus elective surgery (1·67 [1·06–2·63], p = 0·026), and major versus minor surgery (1·52 [1·01–2·31], p = 0·047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than normal practice, particularly in men aged 70 years and older.

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Road Traffic Injury During the COVID-19 Pandemic: Cured or a Continued Threat?

University of Toronto Journal of Public Health ◽

10.33137/utjph.v2i1.34737 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Nahomi Amberber ◽

Andrew Howard ◽

Meghan Winters ◽

M. Anne Harris ◽

Ian Pike ◽

...

Keyword(s):

Public Health ◽

Road Safety ◽

Injury Severity ◽

Road Traffic ◽

Road Traffic Injury ◽

Public Health Approach ◽

Road Transportation ◽

Traffic Injury ◽

Traffic Volumes ◽

Simultaneous Decrease

Road traffic injury, one of the leading causes of preventable morbidity and mortality in Canada, declined substantially as an indirect outcome of the first wave of the COVID-19 pandemic. Public health policies encouraging people to ‘stay at home’ and ‘practice physical distancing’ precipitated shifts in vehicle volumes and speed, transportation mode, and collision rates. Toronto data from January to June 2020 showed a decrease in road transportation, and a simultaneous decrease in road traffic collisions. However, reduced traffic volumes also led to increased vehicle speeds which can result in an increase in injury severity involving pedestrians and cyclists. As the pandemic progresses, an emphasis on safe, active transportation and equitable distribution of street infrastructure throughout the city is essential. A public health approach to road safety includes implementation of evidence-based road safety infrastructure enabled by access to timely transportation data to evaluate changes made.

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