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Long term health outcomes after injury in working age adults: a systematic review
  1. C M Cameron1,
  2. E V Kliewer2,3,4,
  3. D M Purdie5,
  4. R J McClure1
  1. 1School of Medicine, Griffith University, Logan, Australia
  2. 2Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Canada
  3. 3Department of Community Health Sciences, University of Manitoba, Canada
  4. 4School of Public Health, University of Sydney, Australia
  5. 5Queensland Institute of Medical Research, Queensland, Australia
  1. Correspondence to:
 Dr C Cameron
 School of Medicine, Logan Campus, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia; cate.cameron{at}


Background: Estimating the contribution of non-fatal injury outcomes remains a considerable challenge and is one of the most difficult components of burden of disease analysis. The aim of this systematic review was to quantify the effect of being injured compared with not being injured on morbidity and health service use (HSU) in working age adults.

Methods: Studies were selected that were population based, had long term health outcomes measured, included a non-injured comparison group, and related to working age adults. Meta-analysis was not attempted because of the heterogeneity between studies.

Results: Nine studies met the inclusion criteria. In general, studies found an overall positive association between injury and increased HSU, exceeding that of the general population, which in some studies persisted for up to 50 years after injury. Disease outcome studies after injury were less consistent, with null findings reported.

Conclusion: Because of the limited injury types studied and heterogeneity between study outcome measures and follow up, there is insufficient published evidence on which to calculate population estimates of long term morbidity, where injury is a component cause. However, the review does suggest injured people have an increased risk of long term HSU that is not accounted for in current methods of quantifying injury burden.

  • CI, confidence interval
  • HI, head injury
  • HSU, health service use
  • IRR, incidence rate ratio
  • SCI, spinal cord injury
  • TBI, traumatic brain injury
  • injury
  • morbidity
  • health service use
  • review
  • epidemiology
  • population based
  • burden

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  • Funding: none.

  • Conflicts of interest: none.

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