Pre-injury health-related factors in relation to self-reported whiplash: longitudinal data from the HUNT study, Norway

Abstract

Purpose To examine if pre-injury health-related factors are associated with the subsequent report of whiplash, and more specifically, both whiplash and neck pain. Methods Longitudinal population study of 40,751 persons participating in two consecutive health surveys with 11 years interval. We used logistic regression to estimate odds ratio (OR) for reporting whiplash or whiplash with neck pain lasting at least 3 months last year, related to preinjury health as indicated by subjective health, mental and physical impairment, use of health services, and use of medication. All associations were adjusted for sociodemographic factors. Results The OR for reporting whiplash was increased in people reporting poor health at baseline. The ORs varied from 1.47 (95% CI 1.13-1.91) in people visiting a general practitioner (GP) last year to 3.07 (95% CI 2.00-4.73) in people who reported poor subjective health. The OR associated with physical impairment and mental impairment was 2.69 (95% CI 1.75-4.14) and 2.49 (95% CI 1.31-4.74), respectively. Analysis of reporting both whiplash and neck pain gave somewhat stronger association, with ORs varying from 1.50 (95% CI 1.07-2.09) in people visiting a GP last year to 5.70 (95% CI 3.18-10.23) in people reporting poor subjective health. Physical impairment was associated with an OR of 3.48 (95% CI 2.12-5.69) and mental impairment with an OR of 3.02 (95% CI 1.46-6.22). Conclusion Impaired self-reported pre-injury health was strongly associated with the reporting of a whiplash trauma, especially in conjunction with neck pain. This may indicate that individuals have, already before the trauma, adopted an illness role or behaviour which is extended into and influence the report of a whiplash injury. The finding is in support of a functional somatic disorder model for whiplash.

A population‐based, incidence cohort study of mid‐back pain after traffic collisions: Factors associated with global recovery

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Healthcare consultation and sick leave before and after neck injury: a cohort study with matched population-based references

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WHAT HAPPENS WHEN COMPENSATIONFOR WHIPLASH CLAIMS Is MADE MORE GENEROUS?

“…The characteristics of the data are crucial in three ways. First, people with poor prewhiplash health are more likely to be adversely affected by a whiplash and to claim compensation (Wenzel et al, ). The data set allows us to characterize claimants in terms of a large number of relevant variables, such as disability, income, prescription drug use, hospitalization, and health‐care consultations, all observed before the whiplash.…”