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Acute stress response and recovery after whiplash injuries. A one‐year prospective study
Author(s) -
Kongsted Alice,
Bendix Tom,
Qerama Erisela,
Kasch Helge,
Bach Flemming W.,
Korsholm Lars,
Jensen Troels S.
Publication year - 2008
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2007.07.008
Subject(s) - whiplash , medicine , neck pain , physical therapy , prospective cohort study , injury prevention , occupational safety and health , poison control , emergency medicine , alternative medicine , pathology
Chronic whiplash‐associated disorder (WAD) represents a major medical and psycho‐social problem. The typical symptomatology presented in WAD is to some extent similar to symptoms of post traumatic stress disorder. In this study we examined if the acute stress reaction following a whiplash injury predicted long‐term sequelae. Participants with acute whiplash‐associated symptoms after a motor vehicle accident were recruited from emergency units and general practitioners. The predictor variable was the sum score of the impact of event scale (IES) completed within 10 days after the accident. The main outcome‐measures were neck pain and headache, neck disability, general health, and working ability one year after the accident. A total of 737 participants were included and completed the IES, and 668 (91%) participated in the 1‐year follow‐up. A baseline IES‐score denoting a moderate to severe stress response was obtained by 13% of the participants. This was associated with increased risk of considerable persistent pain (OR=3.3; 1.8–5.9), neck disability (OR=3.2; 1.7–6.0), reduced working ability (OR=2.8; 1.6–4.9), and lowered self‐reported general health one year after the accident. These associations were modified by baseline neck pain intensity. It was not possible to distinguish between participants who recovered and those who did not by means of the IES (AUC=0.6). In conclusion, the association between the acute stress reaction and persistent WAD suggests that post traumatic stress reaction may be important to consider in the early management of whiplash injury. However, the emotional response did not predict chronicity in individuals.