Injuries are a significant cause of death and burden of disease in the UK. Types of injury include broken bones, dislocations, wounds, burns and damage to blood vessels, nerves, muscles and tendons. Common causes of injury include road traffic incidents, falls, drowning and intentional infliction. Injured people can be at increased risk of developing other conditions.
The aim of this study is to describe, over time, the number of people in the UK who have been injured or poisoned or experienced accidents that can lead to injury or death. We will also estimate the healthcare costs associated with managing these conditions. How often these injuries occur in our population plays an important role in planning NHS services and highlighting areas for future research and development.
Research-quality patients with an injury or poisoning or have experienced an accident or other event that causes injury or death will be selected. The number of people experiencing an injury, poisoning or an event leading to injury or death (the incidence) will then be calculated on a yearly basis for the duration of the data source, and the proportion of people having that injury, poisoning or event of interest in a given year (the prevalence) will be calculated over the same period. Time to death and patients’ characteristics will be presented. The frequency and cost of primary care consultations, prescriptions, outpatient attendances and inpatient stays will also be determined.
We aim to determine the descriptive epidemiology of injuries, poisonings and their causes and estimate and cost healthcare use in people with these conditions. Acceptable patients will be selected from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets if they have a medical code indicative of an injury, poisoning or external cause of morbidity or mortality. For sensitivity analyses, a subcohort will comprise English patients eligible for linkage to the HES admitted patient care (APC) and outpatient datasets, and their Office for National Statistics (ONS) death registration data. The start of CPRD follow-up will be defined as the later of the patient’s registration date and, in CPRD GOLD, their practice’s up-to-standard date; the end of CPRD data follow-up will be defined as the earliest of the patient’s transfer-out date, date of death (if applicable), and the last data-collection date for their practice. The presentation date will be defined as that of the patient’s first ever record with a code indicative of a relevant event. Incident patients will be selected if their presentation date occurs at least 90 days after registration. Time to death will be presented using Kaplan–Meier analysis. Healthcare resource use and costs will be estimated before and after presentation and comprise primary care contacts, primary care prescriptions, outpatient attendances and hospital admissions. Healthcare costs will be compared with a non-exposed control group of acceptable, HES eligible patients matched in a 1:1 ratio on age, sex, registration status at the date of the case’s start of follow-up and general practice where appropriate. Quintiles of deprivation score will be described. Incidence and point prevalence will be calculated on a yearly basis.
This study will provide valuable information on the healthcare burden associated with injuries and help to inform healthcare decision-making.
Patient characteristics; Comorbidities; Healthcare resource use; Healthcare costs; All-cause mortality; Cause-specific mortality; Incidence; Prevalence
Craig Currie - Chief Investigator - Pharmatelligence Limited t/a Human Data Sciences
Sarah Holden - Corresponding Applicant - Pharmatelligence Limited t/a Human Data Sciences
Benjamin Heywood - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Bethan Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Chris Shepherd - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christian Bannister - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christopher Morgan - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Darren Summers - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Elgan Mathias - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Ellen Hubbuck - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
James Bateman - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Rhiannon Thomason - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Sara Jenkins-Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Thomas Berni - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Practice Level Index of Multiple Deprivation