The effect of socio-demographic and crash-related factors on the prognosis of whiplash
The effect of socio-demographic and crash-related factors on the prognosis of whiplash
复制标题
DOI：
10.1016/s0895-4356(98)00011-0
复制
发表时间：
1998-05-01
影响因子：
7.2
通讯作者：
Suissa, S
中科院分区：
文献类型：
--
作者：
Harder, S;Veilleux, M;Suissa, S
鞭击伤是机动车碰撞后常见的一种损伤，预后不稳定，很难预测。为了评估各种因素对这一预后的影响，我们收集了一组3014人的历史队列，这些人在1981年加拿大魁北克省的一次机动车碰撞中遭受鞭打伤害，并进行了6年的跟踪调查。这些数据是从该省汽车保险计划和警方事故报告创建的计算机化数据库中获得的。以补偿时间衡量的鞭打恢复时间是主要结果。对坠机时测量的社会人口和坠机相关因素进行了调查。队列的中位恢复时间为31天，22%的患者在一周内恢复，3%的患者在1年后仍未恢复。对于1551名仅有鞭打损伤的受试者，在这一队列中，被发现与鞭伤恢复较慢独立相关的社会人口因素是女性、年龄较大、有家属和没有全职工作。与撞车相关的重要因素有：坐在卡车或公交车上，是车上的乘客，与移动物体相撞，以及迎头相撞或垂直相撞。我们根据这些因素得出的预测分数从0到11对受试者进行了分类。得分在0到2之间的受试者，即那些最多存在两个危险因素的受试者，恢复时间的中位数最快，为19天，而得分为6或更高的受试者为71天。我们的结论是，几个社会人口学和撞车相关的因素独立地与鞭打损伤恢复缓慢且代价高昂有关。它们在撞车时很容易测量，并合并在一起，以便简单地纳入旨在早期识别和管理预后较差的鞭打患者的干预计划。(C)1998年爱思唯尔科学公司。
Whiplash injury, common after a motor vehicle crash, has a variable prognosis that is difficult to predict. To assess the role of various factors on this prognosis, we assembled a historical cohort of 3014 individuals who sustained a whiplash injury resulting from a motor vehicle crash in the Province of Quebec, Canada, in 1981 and were followed for 6 years. The data were obtained from the computerized databases created by the province's universal automobile insurance plan and police accident reports. The recovery time from whiplash, as measured by duration of compensation, was the primary outcome. Socio-demographic and crash-related factors measured at the time of the crash were investigated. The median recovery time for the cohort was 31 days, with 22% recovering within a week and 3% still not recovered after 1 year. For the 1551 subjects with a whiplash injury only, the socio demographic factors that were found to be independently associated with a slower recovery from whiplash in this cohort are female gender, older age, having dependents, and not having full-time employment. The significant crash-related factors are occupancy in a truck or bus, being a passenger in the vehicle, colliding with a moving object, and being in a head-on or perpendicular collision. We classified the subjects according to a prediction score ranging from 0 to 11, devised from these factors. Subjects with a score of 0 to 2, that is those who had at most two risk factors present, had the fastest median recovery time of 19 days compared with 71 days for subjects who had a score of 6 or more. We conclude that several sociodemographic and crash-related factors are independently associated with a slow and costly recovery from whiplash injury. They are easily measurable at the time of the crash and combined so as to be simply incorporated in intervention programs aimed at early identification and management of whiplash patients with a poor prognosis. (C) 1998 Elsevier Science Inc.