Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals

• Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries.  Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap -- Rättsmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences -- Forensic Science (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

TEKNIK OCH TEKNOLOGIER  -- Samhällsbyggnadsteknik -- Transportteknik och logistik (hsv//swe)

ENGINEERING AND TECHNOLOGY  -- Civil Engineering -- Transport Systems and Logistics (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

Nyckelord

Sequence analysis

Bicycle crash

Longitudinal cohort

Traffic injury

Sick leave

Disability pension, real-world data

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