[Relevant factors in medico-legal prognosis of whiplash injury].
OBJECTIVE
Whiplash injury (WI) is commonly evaluated in medico-legal practice. With the aim of knowing the determining factors of WI's medico-legal prognosis, a prospective and observational study was carried out.


METHODS
One hundred and twenty consecutive patients who were clinically observed and evaluated in the Medico-Legal Clinic of Barcelona were studied. Socio-demographic, clinical, radiographic and evolutive factors were analyzed.


RESULTS
We included 120 patients with a mean age of 35.6 (14) years (range, 4-74), with a homogeneous male/female distribution. An earlier cervical pathology was detected in 10% of patients; none of them had previous psychiatric pathology. 95% corresponded to road-traffic accident cases and there were 5 aggression cases. Over 50% of cases involved a rear-end collision. All patients had neck pain, almost 25% had headache and 13% had paresthesia. According to the Whiplash Association Disorders clinical classification, distribution in grades (G) was: G I 51%, G II 32% and G III 17%. Patients reported recovery within a mean time of 71.6 (46) days (range, 4-244), with 51,2 (45) no working days (range, 0-180 days). The 52% of the patients rest with complains. According to the recovery time, the following medico-legal prognostic factors were identified: age (p < 0.001), being female (p = 0.001), clinical grade (p < 0.001) and abnormal cervical MRI exploration (p < 0.001). Patients with previous cervical pathology reported more complaints (p = 0.001).


CONCLUSIONS
In our study, WI affected young people of both sex mainly during rear-end collision. Worst medico-legal prognostic factors were age, being females, severity of initial clinical symptoms, previous cervical pathology and abnormal cervical MRI/CT.
Pujol
Amadeo
A
Servei de Clínica Mèdico-Forense. Institut de Medicina Legal de Catalunya. Barcelona. España. 12703apr@comb.es
Puig
Luisa
L
Mansilla
Joaquina
J
Idiaquez
Itziar
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005554:Forensic Medicine / Q000706:statistics & numerical data*; D006801:Humans; D016365:Liability, Legal; D008297:Male; D008875:Middle Aged; D013030:Spain; D014911:Whiplash Injuries / Q000453:epidemiology / Q000503:physiopathology