title: Whiplash associated disorder: incidence and natural history over the first month for patients presenting to a UK emergency department.
abstract: OBJECTIVE
  To describe the epidemiology, process of care, and outcomes at 4-6 weeks after injury among patients with whiplash associated disorder attending a UK emergency department.
  
  
  METHODS
  All patients presenting during the study period with neck pain following a road traffic accident who met the inclusion criteria were assessed. Patients were followed up with a telephone interview at 4-6 weeks after attendance using the Neck Disability Index (NDI). The patient's general practitioner (GP) was contacted post attendance to ascertain subsequent healthcare use.
  
  
  RESULTS
  A total of 200 patients were recruited to the study, of which 30 were lost to follow up. Four variables, midline tenderness (p = 0.008; 95% CI 0.9 to 6.1), x ray request (p = 0.004; 0.9 to 6.1), wearing a seat belt (p = 0.038; 0.2 to 6.2), and having seen their GP post injury (p = 0.001; CI -10.5 to 6.6), were found to be associated with a higher NDI score at follow up. Significant correlation was identified with a high pain score and an increasing age of patient and high NDI scores. No correlation was found between the impact speed, speed of vehicle struck, or time since incident with the NDI. Two thirds of patients had some disability at 4-6 weeks after injury; 91 patients (54.5%) saw their GP in the intervening period between attending the department and telephone follow up, and 87/170 patients had no idea about their prognosis.
  
  
  CONCLUSIONS
  This study identifies that there is significant disability associated with whiplash associated disorder. Clear prognostic information would be a useful development.
authors.affiliation: Emergency Department, Southampton General Hospital, Southampton, Hampshire, SO16 6YD, UK. Robert.Crouch@suht.swest.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: Crouch
authors.forename: R
authors.initials: R
authors.lastname: Whitewick
authors.forename: M
authors.initials: M
authors.lastname: Clancy
authors.forename: P
authors.initials: P
authors.lastname: Wright
authors.forename: P
authors.initials: P
authors.lastname: Thomas
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012622:Seat Belts / Q000706:statistics & numerical data; D014911:Whiplash Injuries / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy