THE EFFECT OF SOCIODEMOGRAPHIC AND CRASH-RELATED FACTORS ON THE PROGNOSIS OF WHIPLASH

Whiplash injury, common after a motor vehicle crash, has a variable pr ognosis that is difficult to predict. To assess the role of various fa ctors on this prognosis, we assembled a historical cohort of 3014 indi viduals who sustained a whiplash injury resulting from a motor vehicle crash in the Province of Quebec, Canada, in 1981 and were followed fo r 6 years. The data were obtained from the computerized databases crea ted by the province's universal automobile insurance plan and police a ccident reports. The recovery time from whiplash, as measured by durat ion of compensation, was the primary outcome. Socio-demographic and cr ash-related factors measured at the time of the crash were investigate d. The median recovery time for the cohort was 31 days, with 22% recov ering within a week and 3% still not recovered after 1 year. For the 1 551 subjects with a whiplash injury only, the socio demographic factor s that were found to be independently associated with a slower recover y from whiplash in this cohort are female gender, older age, having de pendents, and not having full-time employment. The significant crash-r elated factors are occupancy in a truck or bus, being a passenger in t he vehicle, colliding with a moving object, and being in a head-on or perpendicular collision. We classified the subjects according to a pre diction score ranging from 0 to 11, devised from these factors. Subjec ts with a score of 0 to 2, that is those who had at most two risk fact ors present, had the fastest median recovery time of 19 days compared with 71 days for subjects who had a score of 6 or more. We conclude th at several sociodemographic and crash-related factors are independentl y associated with a slow and costly recovery from whiplash injury. The y are easily measurable at the time of the crash and combined so as to be simply incorporated in intervention programs aimed at early identi fication and management of whiplash patients with a poor prognosis. (C ) 1998 Elsevier Science Inc.