Factors related to non-recovery from whiplash. The Nord-Trøndelag Health Study (HUNT).
BACKGROUND
Whiplash injuries show a variable prognosis which is difficult to predict. Most individuals experiencing whiplash injuries rapidly recover but a significant proportion develop chronic symptoms and ongoing disability.


OBJECTIVE
By employing longitudinal data, we investigated how psychological and physical symptoms, self-rated health, use of health services and medications, health behavior and demographic factors predict recovery from whiplash.


METHODS
Data from two waves of a large, Norwegian, population-based study (The Nord-Trøndelag Health Study: HUNT2 and HUNT3) were used. Individuals reporting whiplash in HUNT2 (baseline) were identified in HUNT3 11 years later. The characteristics of individuals still suffering from whiplash in HUNT3 were compared with the characteristics of individuals who had recovered using Pearson's chi-squared test, independent sample t-tests and logistic regression.


RESULTS
At follow-up, 31.6 % of those reporting whiplash at baseline had not recovered. These individuals (n = 199) reported worse health at baseline than recovered individuals (n = 431); they reported poorer self-rated health (odds ratio [OR] = 3.12; 95 % confidence interval [CI], 2.20-4.43), more symptoms of anxiety (OR = 1.70; 95 % CI, 1.15-2.50), more diffuse somatic symptoms (OR = 2.38; 95 % CI, 1.61-3.51) and more musculoskeletal symptoms (OR = 1.21; 95 % CI, 1.13-1.29). Individuals still suffering from whiplash also visited more health practitioners at baseline (OR = 1.18; 95 % CI, 1.06-1.32) and used more medications (OR = 1.24; 95 % CI, 1.09-1.40).


CONCLUSIONS
Poor self-rated health seems to be a strong risk factor for whiplash injuries becoming chronic. Diffuse somatic symptoms, musculoskeletal symptoms and symptoms of anxiety at baseline are important prognostic risk factors. Knowledge of these maintaining risk factors enables identification of individuals at risk of non-recovery, facilitating adequate treatment for this vulnerable group.
Department of Clinical Science, University of Bergen, FHI PHSP, Kalfarveien 31, 5018, Bergen, Norway, makalani.myrtveit@med.uib.no.
Solbjørg Makalani
SM
Myrtveit
Jens Christoffer
JC
Skogen
Keith J
KJ
Petrie
Ingvard
I
Wilhelmsen
Hanne Gro
HG
Wenzel
Børge
B
Sivertsen
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications; D016009:Chi-Square Distribution; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications; D009664:Norway / Q000453:epidemiology; D020127:Recovery of Function; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000150:complications; D014911:Whiplash Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D055815:Young Adult