Longitudinal assessment of quality of life and its change in relation to motor vehicle crashes: The SUN (Seguimiento Universidad de Navarra) cohort

Background: Despite the prevailing notion than injury victims are healthy subjects, there is scarce evidence on their preinjury health status, particularly for motor vehicle crash (MVC) victims, where changes between their preinjury health status (or age- and sex-adjusted standards) have seldom been compared with their postinjury status. Methods: This longitudinal study recorded pre-event self-reported health status (as measured by Short Form-36 scores) of cohort participants who were followed up for 4 years. Differences at the beginning and the end of follow-up as well as differences in Short Form-36 scores changes over time were compared according to the occurrence of a MVC during that time. Results: From 3,361 participants included for analysis, 64 had an incident MVC. At baseline, those participants who would not have subsequently a MVC had better health than those who would have it. In addition, those who reported being in a crash lost more health after the crash than their noncrash counterparts, although these differences were only seen in adjusted analyses. Adjusted analyses showed a significantly greater worsening of health in MVC victims, particularly in regards to role physical (adjusted difference in 4 years change, -7.7; 95% CI, -13.6 to -1.9), bodily pain (-5.9; 95% CI, -11.4 to -0.3), and role emotional (-6.2; 95% CI, -12.5 to -0.02). In this cohort, participants who eventually suffered a crash had a worse health status before their MVC than those who did not suffer a MVC. They lost even further health after the injurious event. These findings bear particular relevance when assessing the burden of disease, or when conducting effectiveness evaluation studies at the individual and population level.