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Type: Journal article
Title: Risk factors for prolonged disability after whiplash injury: a prospective study
Author: Gun, R.
Osti, O.
ORiordan, A.
Mpelasoka, F.
Eckerwall, C.
Smyth, J.
Citation: Spine, 2005; 30(4):386-391
Publisher: Lippincott Williams & Wilkins
Issue Date: 2005
ISSN: 0362-2436
Statement of
Richard Townsend Gun, Orso Lorenzo Osti, Alison O’Riordan, Freddie Mpelasoka, Claes Goran Mikael Eckerwall, and James Farrell Smyth
Abstract: <h4>Study design</h4>A prospective study of 135 patients with whiplash injury.<h4>Objectives</h4>To identify factors predictive of prolonged disability following whiplash injury.<h4>Summary of background data</h4>Although patients with whiplash associated disorders lack demonstrable physical injury, many exhibit prolonged disability. Disability appears unrelated to the severity of the collision.<h4>Methods</h4>A total of 147 patients with recent whiplash injury were interviewed for putative risk factors for disability, and 135 were reinterviewed 12 months later to assess degree and duration of disability. Bivariate and multivariate analyses were undertaken to measure the association between putative risk factors and measures of outcome (change in Neck Pain Outcome Score [NPOS] and visual analogue pain score [VAPS], return to work, still requiring treatment, settlement of claim).<h4>Results</h4>The bodily pain score and role emotional scores of the Short Form-36 health questionnaire showed a consistent significant positive association with better outcomes. After adjustment for bodily pain score and role emotional scores, consulting a lawyer was associated with less improvement in NPOS (P < 0.05), but there was no association with change in VAPS. Consulting a lawyer was associated with a lesser chance of claim settlement (P < 0.01) and a greater chance of still having treatment (P < 0.01) after 1 year, but there was no significant association with a return to work. The degree of damage to the vehicle was not a predictor of outcome.<h4>Conclusions</h4>Short Form-36 scores for bodily pain and role emotional are useful means of identifying patients at risk of prolonged disability. The findings support the implementation of an insurance system designed to minimize litigation.
Keywords: Humans
Whiplash Injuries
Pain Measurement
Linear Models
Risk Factors
Follow-Up Studies
Prospective Studies
Predictive Value of Tests
Middle Aged
Disabled Persons
Surveys and Questionnaires
DOI: 10.1097/
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