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Measuring the Population Burden of Injuries—Implications for Global and National Estimates: A Multi-centre Prospective UK Longitudinal Study
PLoS Medicine, Volume: 8, Issue: 12, Start page: e1001140
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Background: Current methods of measuring the population burden of injuries rely on many assumptions and limited dataavailable to the global burden of diseases (GBD) studies. The aim of this study was to compare the population burden ofinjuries using different approaches from the UK Burden of Injury...
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Background: Current methods of measuring the population burden of injuries rely on many assumptions and limited dataavailable to the global burden of diseases (GBD) studies. The aim of this study was to compare the population burden ofinjuries using different approaches from the UK Burden of Injury (UKBOI) and GBD studies.Methods and Findings: The UKBOI was a prospective cohort of 1,517 injured individuals that collected patient-reportedoutcomes. Extrapolated outcome data were combined with multiple sources of morbidity and mortality data to derivepopulation metrics of the burden of injury in the UK. Participants were injured patients recruited from hospitals in four UKcities and towns: Swansea, Nottingham, Bristol, and Guildford, between September 2005 and April 2007. Patient-reportedchanges in quality of life using the EQ-5D at baseline, 1, 4, and 12 months after injury provided disability weights used tocalculate the years lived with disability (YLDs) component of disability adjusted life years (DALYs). DALYs were calculated forthe UK and extrapolated to global estimates using both UKBOI and GBD disability weights. Estimated numbers (and ratesper 100,000) for UK population extrapolations were 750,999 (1,240) for hospital admissions, 7,982,947 (13,339) foremergency department (ED) attendances, and 22,185 (36.8) for injury-related deaths in 2005. Nonadmitted ED-treatedinjuries accounted for 67% of YLDs. Estimates for UK DALYs amounted to 1,771,486 (82% due to YLDs), compared with669,822 (52% due to YLDs) using the GBD approach. Extrapolating patient-derived disability weights to GBD estimateswould increase injury-related DALYs 2.6-fold.Conclusions: The use of disability weights derived from patient experiences combined with additional morbidity data onED-treated patients and inpatients suggests that the absolute burden of injury is higher than previously estimated. Thesefindings have substantial implications for improving measurement of the national and global burden of injury.
injury; Global Burden of Diseases; DALY; UK
Swansea University Medical School