Prognostic factors for chronic neck pain in persons with minor or moderate injuries in traffic accidents.
Prognostic factors for chronic neck pain were identified in a prospective Norwegian insurance cohort comprising 636 persons with minor or moderate traffic injuries. One questionnaire was used at baseline and another at 3 years post-injury. Daily severe or very severe neck pain at three years follow up was defined as chronic neck pain. Eight significant independent prognostic factors for chronic neck pain were identified: (1) rear-end or frontal and rear-end collision, odds ratio (OR): 4.10 (95% confidence interval (CI): 1.72-10.82); (2) neck and/or shoulder pain before the accident, OR: 2.38 (95% CI: 1.07-5.37); (3) post-accident (a) memory and concentration problems, OR: 4.62 (95% CI: 1.99-11.20), (b) bodily tension, OR: 3.43 (95% CI: 1.49-8.42), (c) difficulties to climb stairs, OR: 5.03 (95% CI: 1.77-14.95), (d) difficulties to bend forward, OR: 4.85 (95% CI: 2.06-11.79), (e) difficulties to do heavy labour, OR: 3.70 (95% CI: 1.24-11.64); (4) beliefs in future work disability, OR: 2.64 (95% CI: 1.11-6.48). The results indicate that development of chronic neck pain is influenced by pre-accident neck and/or shoulder pain, the impact of the collision, as well as post-accident symptoms, perceived impaired function and pessimism for the future ability to work.
Pape
Eivind
E
Expert Services Medicine, If P and C Insurance Company Ltd., P.O. Box 240, 1326 Lysaker, Norway.
Brox
Jens Ivar
JI
Hagen
Kåre Birger
KB
Natvig
Bård
B
Schirmer
Helge
H
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D002908:Chronic Disease; D016001:Confidence Intervals; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000453:epidemiology* / Q000209:etiology; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012449:Safety / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000453:epidemiology* / Q000503:physiopathology