ABSTRACT
OBJECTIVE: To assess the association between Injury Severity Score (ISS) and subsequent risk of early retirement. DESIGN: Observational cohort study with follow-up based on prospectively collected data. Hospital-based data were linked to national register data on pension reception and vital status. SETTING: Level-one urban trauma centre. PARTICIPANTS: Patients aged 18-64 years entering the trauma centre in Copenhagen during 1999-2007 who were alive after three days were followed until early retirement, death or emigration. MAIN OUTCOME MEASURES: Primary outcome was early retirement, defined as receiving disability pension (unintentional) or voluntary early retirement pension (intentional) before the regular age of retirement (65 years). Relative risk of early retirement according to ISS (low, ISS 1-15 vs. high, ISS 16-75) was assessed using Cox proportional hazards regression, adjusted for age and gender. RESULTS: Of all 6687 patients admitted to the trauma centre, a total of 1722 trauma patients were included and followed for a median of 6.2 years (interquartile range (IQR) 3.7-9.1). Of these, 1305 (75.8%) were males, median age was 35.0 years (IQR 25.4-46.5), and median ISS was 16 (IQR 9-25). Three hundred and twenty-two patients retired during follow-up. Patients with high ISS, compared to patients with low ISS, had an increased risk of early retirement, adjusted hazard ratio 2.60 (95% confidence interval (CI) 2.05-3.30; p<0.001). Relative increase in retirement risk was 1.04 (95% CI 1.03-1.05) per ISS point and 1.03 (95% CI 1.03-1.04) per year older. Gender was not found to be a significant risk factor (p=0.69). Five-year absolute risks of early retirement were 9.9% (95% CI 7.8-12.0%) for the low ISS group and 24.6% (95% CI 21.6-27.5%) for the high ISS group. CONCLUSIONS: The risk of early retirement is 2.6 times higher in severely injured patients (ISS 16-75) than the risk in low to moderately injured patients (ISS 1-15) and they have a high absolute 5-year risk as well. Early, targeted interventions to assist with return to work might be able to reduce this risk.
Subject(s)
Disabled Persons/statistics & numerical data , Quality of Life , Retirement/statistics & numerical data , Return to Work/statistics & numerical data , Wounds and Injuries/complications , Wounds and Injuries/epidemiology , Adolescent , Adult , Denmark/epidemiology , Disability Evaluation , Female , Follow-Up Studies , Humans , Injury Severity Score , Male , Middle Aged , Outcome Assessment, Health Care , Probability , Prospective Studies , Risk Factors , Trauma Centers/statistics & numerical data , Urban Population , Wounds and Injuries/mortality , Wounds and Injuries/physiopathologyABSTRACT
Seventeen male volunteers were photographed laterally with and without a tight-fitting balaclava. We then matched these photographs in blind trials. The matches were performed in two separate trials: as side-by-side comparisons, and by using superimposition. In both trials we graded the matches as good, possible and no fit. We found a very high true identification rate of 94% using superimposition, i.e. whether a match judged as good was in fact the correct match. The correct exclusion rate was also high, 94%, when using superimposition, i.e. when no match was found this was in fact correct. However, even though we were often correct in judging the best fit, we often had several possible matches for each case, which means that comparing profiles is not very selective. As such, using superimposition to compare the profile of a masked perpetrator with lateral photos of one or more suspects may indicate the possible matches, and perhaps even the best match, which may be helpful in police investigations, but it would not carry enough weight to be used as evidence per se. This study only focused on the profile. Future studies will use surface laser scans to analyse congruence between masked and unmasked subjects using the whole head.
