Quality of life (QOL) of those haing moderate to severe head injuries among road traffic injury (RTI) survivors, age 15-45 yrs. living in Karachi, Pakistan : cross sectional study

Road traffic injuries are predicted to be the third leading contributor to the global burden of disease by 2020. Most of RTA patients end up into head injuries which leave devastating impacts on individual and society. Health related quality of life is considered as an important outcome that recognizes the perception of patients after traumatic brain injury (T131) as compared to generic outcome that is Glasgow coma score extended GOSE., Quality of Life After Brain Injury (QOLIBRI )is a specific tool that measures quality of life in head injury patients. Methods: Worldwide Road traffic accidents (RTA) cause 2.1 percent mortality and 2.6 percent of all disability-adjusted life years (DALYs) lost, with 90 % contribution by low middle income countries. This was a cross sectional study among 300 patients aged 15-45 years, attended emergency department of the Aga khan University. Structured questionnaire included demography, injury details, QOLIBRI, GOSE and WHO disability assessment scale (WHODAS 12 items). Severity of injury was determined by Glasgow coma score of subjects reported in emergency department on admission. Subjects were interviewed on phone at least after six months of RTA, This was one time survey in which bi-directional data was collected from subjects about injury and outcome (QOLIBRI). Student t test and chi square were used to see association between continuous and categorical variables respectively. To identify the determinants of QOL among RTI survivors with head injury multiple linear regressions was applied. Results: At the scale of 0-100 the mean QOL score for study sample was 69.86 ± (15.89. Most of the patients 210 (70%) were motorbike rider followed by four-wheelers 69 (23%). Mean age of RTI participants was 28.10 ± (7.68) years. The quality of life decrease with increase in severity of head injury by -697.32 (95% CI; -1006.44, -388.20). QOL is inversely associated with unemployment of individual and it declines by-529.24 (CI 95%; -845.81, -212.19) among unemployed individuals as compare to employed participants. Conclusions: This study suggests quality of life is one the most important health care outcome for RTA survivors with head injuries. Influence of severity of head injury, recovery time, surgery resultin followg from RTA, employment, family system and disability can be considered in long term up and intervention based program