Natural evolution of late whiplash syndrome outside the medicolegal context
Natural evolution of late whiplash syndrome outside the medicolegal context
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DOI：
10.1016/s0140-6736(96)90733-3
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发表时间：
1996-05-04
期刊：
影响因子：
168.9
通讯作者：
Sand, T
中科院分区：
文献类型：
--
作者：
Schrader, H;Obelieniene, D;Sand, T
背景在立陶宛，很少有汽车司机和乘客被保险覆盖，公众对挥鞭样损伤的潜在致残后果几乎没有认识。我们借此机会，研究自然过程中的头部和颈部症状后，追尾cars collisions.Methods在一项回顾性队列研究中，202人（157名男性，45名女性）被确定为从记录的交警部门在考纳斯，立陶宛。这些人在经历了追尾汽车碰撞后1-3年接受了采访。颈部疼痛、头痛、主观认知功能障碍、心理障碍，将该组患者的颈部疼痛和腰痛与从同一地理区域的人口登记册中随机选择的性别和年龄匹配的未受伤个体的对照组中的相同投诉进行比较。（35% [95%CI 29-42]）事故受害者和67（33% [27-40]）对照组。107名（53% [46-60]）事故受害者和100名（50% [42-57]）对照者报告了头痛。慢性颈部疼痛和慢性头痛（每月超过7天）的报告比例也相似（17 [8]。4%; 5-13]对14 [6 . 9%; 4-12]和19 [9 . 4%; 6-15]对12 [5 . 9%;在事故后报告慢性颈部疼痛或每日头痛的患者中，相当大比例的患者在事故前有类似的症状（7/17为慢性颈部疼痛; 10/12为每日头痛）。研究组中没有人因车祸而出现致残或持续的症状。撞击的严重程度与疼痛程度无关。颈部疼痛的家族史是目前颈部症状的Logistic回归analysis.Interpretation中最重要的危险因素，我们的研究结果表明，慢性症状通常不是由车祸引起的。残疾的预期，家族史，和归因于先前存在的症状的创伤可能是更重要的晚期挥鞭样综合征的演变。
Background In Lithuania, few car drivers and passengers are covered by insurance and there is little awareness among the general public about the potentially disabling consequences of a whiplash injury. We took this opportunity to study the natural course of head and neck symptoms after rear-end car collisions.Methods In a retrospective questionnaire-based cohort study, 202 individuals (157 men; 45 women) were identified from the records of the traffic police department in Kaunas, Lithuania. These individuals were interviewed 1-3 years after experiencing a rear-end car collision. Neck pain, headache, subjective cognitive dysfunction, psychological disorders, and low back pain in this group were compared with the same complaints in a sex-matched and age-matched control group of uninjured individuals selected randomly from the population register of the same geographic area.Findings Neck pain was reported by 71 (35% [95% CI 29-42]) accident victims and 67 (33% [27-40]) controls. Headache was reported by 107 (53% [46-60]) accident victims and 100 (50% [42-57]) controls. Chronic neck pain and chronic headache (more than 7 days per month) were also reported in similar proportions (17 [8 . 4%; 5-13] vs 14 [6 . 9%; 4-12] and 19 [9 . 4%; 6-15] vs 12 [5 . 9%; 3-10]) by the two groups, Of those who reported chronic neck pain or daily headache after the accident, substantial proportions had had similar symptoms before the accident (7/17 for chronic neck pain; 10/12 for daily headache). There was no significant difference found. No one in the study group had disabling or persistent symptoms as a result of the car accident. There was no relation between the impact severity and degree of pain. A family history of neck pain was the most important risk factor for current neck symptoms in logistic regression analyses.Interpretation Our results suggest that chronic symptoms were not usually caused by the car accident. Expectation of disability, a family history, and attribution of pre-existing symptoms to the trauma may be more important for the evolution of the late whiplash syndrome.