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Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study.

Carstensen TB, Fink P, Oernboel E, Kasch H, Jensen TS, Frostholm L - PLoS ONE (2015)

Bottom Line: 10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover.Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors.Neck pain at inclusion predicted future neck pain.

View Article: PubMed Central - PubMed

Affiliation: The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.

ABSTRACT

Background: 10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision.

Methods and findings: 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p < 0.001) and unemployment (χ2(2) = 12.5, p = 0.002)) pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls.

Conclusions: Sick leave before the collision strongly predicted prolonged recovery following whiplash trauma. Participants with acute whiplash trauma had weaker attachment to labour market pre-collision compared with the general population. Neck pain at inclusion predicted future neck pain. Acute whiplash trauma may trigger pre-existing vulnerabilities increasing risk of developing whiplash-associated disorders.

No MeSH data available.


Related in: MedlinePlus

Flow chart of inclusion, exclusion and outcome of whiplash and control cohorts.
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pone.0130298.g002: Flow chart of inclusion, exclusion and outcome of whiplash and control cohorts.

Mentions: 1,495 individuals with acute whiplash trauma were recruited (898 women, 597 men). Initially 740 subjects joined the study of which 19 were not residents in a Danish municipality at the time of the collision, and the Civil Registration System number of 2 participants could not be obtained. 755 were excluded for other reasons (Fig 2). The mean age of the included 719 participants with acute WAD was 34.4 years, and 64.4% of the sample was female. Among the 548 subjects ineligible for inclusion the percentage of men was statistically significantly higher than among subjects participating (42% versus 36%) (χ2(1) = 4.86, p = 0.05). Also, among the 200 subjects declining participation, the percentage of men was statistically significantly higher (49% versus 36%) (χ2(1) = 10.8, p = 0.001) than among participants. The 53 subjects lost to follow-up did not differ from those completing with respect to gender but were statistically significantly younger (mean age 31.1 versus 35.2) (Mann Whitney’s U Z = 2.5, p = 0.01).


Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study.

Carstensen TB, Fink P, Oernboel E, Kasch H, Jensen TS, Frostholm L - PLoS ONE (2015)

Flow chart of inclusion, exclusion and outcome of whiplash and control cohorts.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476609&req=5

pone.0130298.g002: Flow chart of inclusion, exclusion and outcome of whiplash and control cohorts.
Mentions: 1,495 individuals with acute whiplash trauma were recruited (898 women, 597 men). Initially 740 subjects joined the study of which 19 were not residents in a Danish municipality at the time of the collision, and the Civil Registration System number of 2 participants could not be obtained. 755 were excluded for other reasons (Fig 2). The mean age of the included 719 participants with acute WAD was 34.4 years, and 64.4% of the sample was female. Among the 548 subjects ineligible for inclusion the percentage of men was statistically significantly higher than among subjects participating (42% versus 36%) (χ2(1) = 4.86, p = 0.05). Also, among the 200 subjects declining participation, the percentage of men was statistically significantly higher (49% versus 36%) (χ2(1) = 10.8, p = 0.001) than among participants. The 53 subjects lost to follow-up did not differ from those completing with respect to gender but were statistically significantly younger (mean age 31.1 versus 35.2) (Mann Whitney’s U Z = 2.5, p = 0.01).

Bottom Line: 10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover.Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors.Neck pain at inclusion predicted future neck pain.

View Article: PubMed Central - PubMed

Affiliation: The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.

ABSTRACT

Background: 10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision.

Methods and findings: 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p < 0.001) and unemployment (χ2(2) = 12.5, p = 0.002)) pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls.

Conclusions: Sick leave before the collision strongly predicted prolonged recovery following whiplash trauma. Participants with acute whiplash trauma had weaker attachment to labour market pre-collision compared with the general population. Neck pain at inclusion predicted future neck pain. Acute whiplash trauma may trigger pre-existing vulnerabilities increasing risk of developing whiplash-associated disorders.

No MeSH data available.


Related in: MedlinePlus