OBJECTIVE: To determine, in a group of persons involved in a motor vehicle collision, the contributions of pre-collision health and psychological factors, the social environment, collision-specific factors, and post-collision symptoms, to the new onset of widespread pain (WP). METHODS: A prospective cohort study of persons, registered with an insurance company, who had recently experienced a motor vehicle collision. Participants were sent a questionnaire to assess pre-collision health, collision-specific factors, post-collision health, and WP. Those reporting WP prior to the collision were excluded from followup. At 12 months, participants were sent a followup questionnaire to ascertain one-month period prevalence of (new onset) WP. RESULTS: In total 957 individuals took part in the baseline survey and were eligible for followup. Subsequently, 695 (73%) completed a questionnaire at 12 months, of whom 54 (7.8%) reported new WP. Few collision-specific factors predicted the onset of WP. In contrast, post-collision physical symptoms (rate ratio 2.5, 95% confidence interval 1.2-5.1), pre-collision health-seeking behavior (RR 3.6, 95% CI 1.6-7.9), pre-collision somatization (RR 1.7, 95% CI 0.99-2.8), and perceived initial injury severity (RR 1.7, 95% CI 0.9-3.3), in addition to older age (RR 3.3, 95% CI 1.5-7.1), were all independently predictive of new onset WP. In combination, these factors accounted for about a 20-fold difference in the risk of new onset WP. CONCLUSION: We identified 5 factors that independently predict the onset of WP following a motor vehicle collision. Early identification of this "at-risk" group may allow the targeting of preventive management in those at highest risk of developing future symptoms.
OBJECTIVE: To determine, in a group of persons involved in a motor vehicle collision, the contributions of pre-collision health and psychological factors, the social environment, collision-specific factors, and post-collision symptoms, to the new onset of widespread pain (WP). METHODS: A prospective cohort study of persons, registered with an insurance company, who had recently experienced a motor vehicle collision. Participants were sent a questionnaire to assess pre-collision health, collision-specific factors, post-collision health, and WP. Those reporting WP prior to the collision were excluded from followup. At 12 months, participants were sent a followup questionnaire to ascertain one-month period prevalence of (new onset) WP. RESULTS: In total 957 individuals took part in the baseline survey and were eligible for followup. Subsequently, 695 (73%) completed a questionnaire at 12 months, of whom 54 (7.8%) reported new WP. Few collision-specific factors predicted the onset of WP. In contrast, post-collision physical symptoms (rate ratio 2.5, 95% confidence interval 1.2-5.1), pre-collision health-seeking behavior (RR 3.6, 95% CI 1.6-7.9), pre-collision somatization (RR 1.7, 95% CI 0.99-2.8), and perceived initial injury severity (RR 1.7, 95% CI 0.9-3.3), in addition to older age (RR 3.3, 95% CI 1.5-7.1), were all independently predictive of new onset WP. In combination, these factors accounted for about a 20-fold difference in the risk of new onset WP. CONCLUSION: We identified 5 factors that independently predict the onset of WP following a motor vehicle collision. Early identification of this "at-risk" group may allow the targeting of preventive management in those at highest risk of developing future symptoms.
Authors: C Sommer; W Häuser; M Burgmer; R Engelhardt; K Gerhold; F Petzke; T Schmidt-Wilcke; M Späth; T Tölle; N Uçeyler; H Wang; A Winkelmann; K Thieme Journal: Schmerz Date: 2012-06 Impact factor: 1.107
Authors: A V Bortsov; T F Platts-Mills; D A Peak; J S Jones; R A Swor; R M Domeier; D C Lee; N K Rathlev; P L Hendry; R B Fillingim; S A McLean Journal: Eur J Pain Date: 2013-01-20 Impact factor: 3.931