Pape Eivind, Brox Jens Ivar, Hagen Kåre Birger, Natvig Bård, Schirmer Helge
Expert Services Medicine, If P and C Insurance Company Ltd., P.O. Box 240, 1326 Lysaker, Norway.
Accid Anal Prev. 2007 Jan;39(1):135-46. doi: 10.1016/j.aap.2006.06.010. Epub 2006 Aug 24.
Prognostic factors for chronic neck pain were identified in a prospective Norwegian insurance cohort comprising 636 persons with minor or moderate traffic injuries. One questionnaire was used at baseline and another at 3 years post-injury. Daily severe or very severe neck pain at three years follow up was defined as chronic neck pain. Eight significant independent prognostic factors for chronic neck pain were identified: (1) rear-end or frontal and rear-end collision, odds ratio (OR): 4.10 (95% confidence interval (CI): 1.72-10.82); (2) neck and/or shoulder pain before the accident, OR: 2.38 (95% CI: 1.07-5.37); (3) post-accident (a) memory and concentration problems, OR: 4.62 (95% CI: 1.99-11.20), (b) bodily tension, OR: 3.43 (95% CI: 1.49-8.42), (c) difficulties to climb stairs, OR: 5.03 (95% CI: 1.77-14.95), (d) difficulties to bend forward, OR: 4.85 (95% CI: 2.06-11.79), (e) difficulties to do heavy labour, OR: 3.70 (95% CI: 1.24-11.64); (4) beliefs in future work disability, OR: 2.64 (95% CI: 1.11-6.48). The results indicate that development of chronic neck pain is influenced by pre-accident neck and/or shoulder pain, the impact of the collision, as well as post-accident symptoms, perceived impaired function and pessimism for the future ability to work.
在一个前瞻性挪威保险队列中确定了慢性颈部疼痛的预后因素,该队列包括636名轻度或中度交通伤患者。在基线时使用一份问卷,在受伤后3年使用另一份问卷。三年随访时每日严重或非常严重的颈部疼痛被定义为慢性颈部疼痛。确定了慢性颈部疼痛的八个显著独立预后因素:(1)追尾或正面及追尾碰撞,优势比(OR):4.10(95%置信区间(CI):1.72 - 10.82);(2)事故前颈部和/或肩部疼痛,OR:2.38(95%CI:1.07 - 5.37);(3)事故后(a)记忆和注意力问题,OR:4.62(95%CI:1.99 - 11.20),(b)身体紧张,OR:3.43(95%CI:1.49 - 8.42),(c)爬楼梯困难,OR:5.03(95%CI:1.77 - 14.95),(d)向前弯腰困难,OR:4.85(95%CI:2.06 - 11.79),(e)从事重体力劳动困难,OR:3.70(95%CI:1.24 - 11.64);(4)对未来工作残疾的信念,OR:2.64(95%CI:1.11 - 6.48)。结果表明,慢性颈部疼痛的发展受事故前颈部和/或肩部疼痛、碰撞的影响以及事故后症状、感知到的功能受损和对未来工作能力的悲观情绪影响。