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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2005 Aug;76(8):1146–1151. doi: 10.1136/jnnp.2004.049189

Whiplash following rear end collisions: a prospective cohort study

L Pobereskin 1
PMCID: PMC1739736  PMID: 16024895

Abstract

Objective: The purpose of this study was to investigate the factors which predict neck pain initially and at 1 year following a rear end collision.

Methods: All people who reported a rear end collision to the Devon and Cornwall Constabulary were identified and formed the basis of the cohort. People were excluded if they were under 18 years of age or had suffered a head injury. The main outcome measures were neck pain lasting for more than a week after the accident and neck pain at least 1 day a week at 1 year. Logistic regression was used to investigate associations between demographic and accident related variables and outcomes.

Results: A total of 1147 people reported rear end collisions to the police during the study period and 503 (44%) agreed to take part in the study. Of the respondents, 78% had neck pain lasting for more than a week and 52% still had pain at 1 year. Age (odds ratio, 95% confidence interval: 0.957, 0.942–0.972) and prior history of neck pain (8.32, 2.89–23.89) were the most important predictors of early neck pain. The most important predictors of pain at 1 year were the initial neck visual analogue scale (VAS) score (1.03, 1.01–1.05) and the presence of a compensation claim (4.09, 1.62–10.32). There was only weak evidence that measures of the severity of the impact were associated with outcomes.

Conclusion: Demographic variables and the presence of a compensation suit show the strongest correlation with acute and chronic neck pain following rear end collisions.

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Selected References

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  1. Cassidy J. D., Carroll L. J., Côté P., Lemstra M., Berglund A., Nygren A. Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med. 2000 Apr 20;342(16):1179–1186. doi: 10.1056/NEJM200004203421606. [DOI] [PubMed] [Google Scholar]
  2. Côté P., Hogg-Johnson S., Cassidy J. D., Carroll L., Frank J. W. The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. J Clin Epidemiol. 2001 Mar;54(3):275–286. doi: 10.1016/s0895-4356(00)00319-x. [DOI] [PubMed] [Google Scholar]
  3. Ferrari R., Schrader H. The late whiplash syndrome: a biopsychosocial approach. J Neurol Neurosurg Psychiatry. 2001 Jun;70(6):722–726. doi: 10.1136/jnnp.70.6.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gargan M. F., Bannister G. C. Long-term prognosis of soft-tissue injuries of the neck. J Bone Joint Surg Br. 1990 Sep;72(5):901–903. doi: 10.1302/0301-620X.72B5.2211780. [DOI] [PubMed] [Google Scholar]
  5. Hohl M. Soft-tissue injuries of the neck in automobile accidents. Factors influencing prognosis. J Bone Joint Surg Am. 1974 Dec;56(8):1675–1682. [PubMed] [Google Scholar]
  6. Kasch H., Stengaard-Pedersen K., Arendt-Nielsen L., Staehelin Jensen T. Headache, neck pain, and neck mobility after acute whiplash injury: a prospective study. Spine (Phila Pa 1976) 2001 Jun 1;26(11):1246–1251. doi: 10.1097/00007632-200106010-00014. [DOI] [PubMed] [Google Scholar]
  7. Mayou R., Bryant B. Outcome of 'whiplash' neck injury. Injury. 1996 Nov;27(9):617–623. doi: 10.1016/s0020-1383(96)00114-3. [DOI] [PubMed] [Google Scholar]
  8. Mayou Richard, Bryant Bridget. Psychiatry of whiplash neck injury. Br J Psychiatry. 2002 May;180:441–448. doi: 10.1192/bjp.180.5.441. [DOI] [PubMed] [Google Scholar]
  9. Norris S. H., Watt I. The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone Joint Surg Br. 1983 Nov;65(5):608–611. doi: 10.1302/0301-620X.65B5.6643566. [DOI] [PubMed] [Google Scholar]
  10. Nygren A. Injuries to car occupants--some aspects of the interior safety of cars. A study of a five-year material from an insurance company. Acta Otolaryngol Suppl. 1984;395:1–164. doi: 10.3109/00016488309139642. [DOI] [PubMed] [Google Scholar]
  11. Obelieniene D., Schrader H., Bovim G., Miseviciene I., Sand T. Pain after whiplash: a prospective controlled inception cohort study. J Neurol Neurosurg Psychiatry. 1999 Mar;66(3):279–283. doi: 10.1136/jnnp.66.3.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Parmar H. V., Raymakers R. Neck injuries from rear impact road traffic accidents: prognosis in persons seeking compensation. Injury. 1993 Feb;24(2):75–78. doi: 10.1016/0020-1383(93)90191-8. [DOI] [PubMed] [Google Scholar]
  13. Partheni M., Constantoyannis C., Ferrari R., Nikiforidis G., Voulgaris S., Papadakis N. A prospective cohort study of the outcome of acute whiplash injury in Greece. Clin Exp Rheumatol. 2000 Jan-Feb;18(1):67–70. [PubMed] [Google Scholar]
  14. Pennie B., Agambar L. Patterns of injury and recovery in whiplash. Injury. 1991 Jan;22(1):57–59. doi: 10.1016/0020-1383(91)90166-c. [DOI] [PubMed] [Google Scholar]
  15. Radanov B. P., Sturzenegger M., Di Stefano G. Long-term outcome after whiplash injury. A 2-year follow-up considering features of injury mechanism and somatic, radiologic, and psychosocial findings. Medicine (Baltimore) 1995 Sep;74(5):281–297. doi: 10.1097/00005792-199509000-00005. [DOI] [PubMed] [Google Scholar]
  16. Schrader H., Obelieniene D., Bovim G., Surkiene D., Mickeviciene D., Miseviciene I., Sand T. Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet. 1996 May 4;347(9010):1207–1211. doi: 10.1016/s0140-6736(96)90733-3. [DOI] [PubMed] [Google Scholar]
  17. Stovner L. J. The nosologic status of the whiplash syndrome: a critical review based on a methodological approach. Spine (Phila Pa 1976) 1996 Dec 1;21(23):2735–2746. doi: 10.1097/00007632-199612010-00006. [DOI] [PubMed] [Google Scholar]
  18. Sturzenegger M., Radanov B. P., Di Stefano G. The effect of accident mechanisms and initial findings on the long-term course of whiplash injury. J Neurol. 1995 Jul;242(7):443–449. doi: 10.1007/BF00873547. [DOI] [PubMed] [Google Scholar]

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