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Increased risk of unintentional injuries in adults with disabilities: a systematic review and meta-analysis
Xiuquan Shi1, Krista K Wheeler2, Junxin Shi2
1Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, OH, USA; Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical College, Zunyi, PR China.
Background:
An increased risk of unintentional injuries among individuals with disability has been reported in many studies, yet quantitative syntheses of findings from previous studies have not been done.
Objectives:
We conducted a systematic review and meta-analysis to characterize the relationship between pre-existing disability and unintentional injuries.
Methods:
We searched 14 electronic databases to identify original research published between Jan 1, 1990 and Feb 28, 2013. Included studies reported the odds ratio (OR) or relative risk (RR) of unintentional injuries in adults 18+ years of age with pre-existing disabilities compared with adults without disabilities. Twenty six eligible studies were included covering 54,586 individuals with disabilities. We conducted quality assessments and then analyzed the pooled effects using random-effect models.
Results:
The pooled OR of unintentional injuries was 1.77 (95% CI 1.51-2.07) for all studies in individuals with disabilities compared with individuals without disabilities. The pooled ORs were 1.87 (95% CI 1.52-2.30) for overall unintentional injuries, 1.64 (95% CI 1.39-1.94) for falls-related injuries, 1.62 (95% CI 1.24-2.13) for occupational injuries, and 1.91 (95% CI 1.59-2.30) for non-occupational injuries.
Conclusions:
Compared with adults without disabilities, individuals with disabilities are at a significantly higher risk of unintentional injuries. Evidence about the association between cognitive disabilities and unintentional injuries is weak. Future researchers are encouraged to use International Classification of Functioning, Disability and Health (ICF) to classify disability and use rigorous evaluation methods to assess and implement the most appropriate injury prevention efforts to mitigate the risks identified.
