Pain after whiplash: a prospective controlled inception cohort study
Pain after whiplash: a prospective controlled inception cohort study
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DOI：
10.1136/jnnp.66.3.279
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发表时间：
1999-03-01
影响因子：
11
通讯作者：
Sand, T
中科院分区：
文献类型：
--
作者：
Obelieniene, D;Schrader, H;Sand, T
目的-在立陶宛，很少有人意识到慢性症状可能是由于追尾碰撞通过所谓的挥鞭样损伤。在大多数这类碰撞之后，与卫生部门没有建立联系。因此，存在一个机会，研究创伤后疼痛没有混淆因素，目前在西方society. Methods，在一个前瞻性的，控制的起始队列研究，210名受害者的追尾碰撞被连续确定从日常记录的考纳斯交通警察。在事故发生后不久、2个月和1年后，通过邮寄问卷对颈部疼痛和头痛进行评估。作为对照，210名性别和年龄相匹配的受试者被随机从同一地理区域的人口登记册，并评估了相同的症状后，立即识别和1年后，结果初始疼痛报告的47%的事故受害者，10%的颈部疼痛，18%的颈部疼痛与头痛，和19%的头痛。初始颈部疼痛的中位持续时间为3天，最长持续时间为17天。头痛的中位持续时间为4.5小时，最长持续时间为20天。1年后，有没有显着差异的事故受害者和对照组之间的频率和强度，这些symptoms. Conclusions，在一个国家是没有先入为主的观念，慢性疼痛所产生的追尾碰撞，因此没有恐惧的长期残疾，通常没有参与的治疗社区，保险公司，或诉讼，急性挥鞭样损伤后的症状是自限性的、短暂的，并且似乎不会发展为所谓的晚期挥鞭样综合征。
Objectives-In Lithuania, there is little awareness of the notion that chronic symptoms may result from rear end collisions via the so-called whiplash injury. After most such collisions no contact with the health service is established. An opportunity therefore exists to study posttraumatic pain without the confounding factors present in western societies.Methods-In a prospective, controlled inception cohort study, 210 victims of a rear end collision were consecutively identified from the daily records of the Kaunas traffic police. Neck pain and headache were evaluated by mailed questionnaires shortly after the accident, after 2 months, and after 1 year. As controls, 210 sex and age matched subjects were randomly taken from the population register of the same geographical area and evaluated for the same symptoms immediately after their identification and after 1 year.Results-Initial pain was reported by 47% of accident victims; 10% had neck pain alone, 18% had neck pain together with headache, and 19% had headache alone. The median duration of the initial neck pain was 3 days and maximal duration 17 days. The median duration of headache was 4.5 hours and the maximum duration was 20 days. After 1 year, there were no significant differences between the accident victims and the control group concerning frequency and intensity of these symptoms.Conclusions-In a country were there is no preconceived notion of chronic pain arising from rear end collisions, and thus no fear of long term disability, and usually no involvement of the therapeutic community, insurance companies, or Litigation, symptoms after an acute whiplash injury are self limiting, brief, and do not seem to evolve to the so-called late whiplash syndrome.