Neither the WAD-classification nor the Quebec Task Force follow-up regimen seems to be important for the outcome after a whiplash injury. A prospective study on 186 consecutive patients.
A classification of injury and a follow-up schedule were proposed by the Quebec Task Force (QTF) in 1995. No general agreement about the clinical usefulness of the WAD-classification or of the suggested follow-up regimen exists. A series of 186 consecutive cases seen in the emergency room during the acute phase after a whiplash injury was prospectively studied for 1 year. All findings including history and physical findings were recorded using standardized QTF protocols. In one group follow-up visits were done according to the QTF regimen: at 1, 3, 6, 12 weeks and 1 year after the accident; in a control group no visit was scheduled. The outcome variable was neck pain at 1 year after the accident. After 1 year, 18% of the total number of patients had significant neck pain. Risk factors for chronic neck pain at 1 year after whiplash injury were: neck pain before the accident and a high degree of emotional distress at the time of the accident; both factors independently associated with a tenfold increased risk of developing chronic neck pain. Neither the WAD classification nor the QTF follow-up regimen could be linked to a better outcome. In this study the outcome was associated with patient-specific characteristics and not with physical signs of injury, the depth of the initial evaluation or the follow-up regimen.
Kivioja
Jouko
J
Division of Orthopaedics, Department of Clinical Intervention and Technology (Huddinge), Karolinska Institute, K54, 141 86, Stockholm, Sweden.
Jensen
Irene
I
Lindgren
Urban
U
D000063:Accidents, Traffic; D000293:Adolescent; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D049669:History, 16th Century; D049670:History, 17th Century; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014911:Whiplash Injuries / Q000145:classification* / Q000150:complications / Q000503:physiopathology