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12-12-2011 | Legal medicine | Article

Disability burden from injuries in the UK much higher than expected


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MedWire News: Injuries in the UK result in over twice as many years of productive life lost due to disability and premature death as previously thought, say researchers.

"Accurate measurement of the burden of injuries is essential to ensure adequate policy responses to prevention and treatment," explain Ronan Lyons (Swansea University, UK) and colleagues.

They therefore combined data from the UK Burden of Injury (UKBOI) study on 1517 people injured between September 2005 and April 2007 in the UK, as well as information collected in the Global Burden of Diseases (GBD) study, to assess the burden of injury sustained and to extrapolate this burden to the UK and worldwide population.

Of the patients recruited, 35.4% were from Swansea, 24.7% from Nottingham, 22.0% from Guildford, and 17.9% from Bristol. The median age of the participants was 37.4 years and most had suffered an accident in the home (34.8%) or a road traffic accident (20.6%). The types of injury were mostly musculoskeletal, but also included open wounds, burns, and poisonings.

The participants filled out the EQ-5D quality of life questionnaire at baseline, and 1, 4, and 12 months after injury. The results of the questionnaires were then used to help calculate disability adjusted life-years (DALYs) for the patients. DALYs are calculated from a combination of years of life lost due to premature mortality and years lived with disability (YLD), which are calculated from disability weights and durations for different injury types in a population.

The DALY findings from this study were then used to estimate UK and Global DALYs using disability weights from the UKBOI and GBD studies.

Lyons et al estimated that there were 1240 hospital admissions, 13,339 emergency department attendances, and 36.8 injury-related deaths per 100,000 people in the UK in 2005.

This resulted in 1,771,486 estimated DALYs for the UK in 2005, 82% of which were due to YLD. Using the GBD patient-derived disability weights to estimate global DALYs resulted in a figure of 669,822 DALYs for the same year, 52% of which were due to YLD.

"While considerable uncertainties remain, our best estimate is that injury-related DALYs are 2.6 times greater than previously thought, and even if we are very conservative and assume that everyone we were unable to follow up had completely recovered from their injury, the estimate of DALYs would still be 1.6 times greater than earlier estimates," commented study author Denise Kendrick (University of Nottingham, UK) in a press statement.

Writing in the journal PLoS Medicine, the authors conclude: "Our results suggest that if the pattern of underestimation seen in the UK was mirrored across the world then injuries may account for up to a quarter of global DALYs rather than a sixth as previously estimated."

By Helen Albert

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