Incidence and outcome of whiplash injury after multiple trauma.

STUDY DESIGN

A retrospective study of 101 consecutive polytrauma patients with regard to whiplash injury.

OBJECTIVES

To investigate the incidence and evaluate long-term outcome of whiplash injury following high-energy trauma.

SUMMARY OF BACKGROUND DATA

Chronic whiplash injury has been widely reported in the literature, following low-energy trauma. Very few studies exist on whiplash injury following high-energy trauma.

METHODS

A total of 101 consecutive polytrauma patients admitted to our Level I Trauma Center over a 2-year period, fulfilling the inclusion criteria (age >18 years, high-energy trauma [a fall from a height >2 m, road traffic accidents with speed >30 km/h], and Injury Severity Score >16), were assessed. Whiplash injury was defined according to Quebec Task Force guidelines. The study group (n = 13) included patients who developed whiplash injury symptoms and the control group (n = 88) those who did not. The Neck Disability Index was calculated as an outcome measure for patients complaining of whiplash injury symptoms. The mean follow-up was 17 months. The chi2 and Student t tests were used for the statistical analysis (SPSS 12.1; SPSS, Inc., Chicago, IL).

RESULTS

Only 13 out of 101 patients (1 female/12 male) (13%) complained of whiplash injury. There was a significantly higher rate of neck pain at triage (P < 0.001) and higher combined mean of Abbreviated Injury Score of upper torso (P < 0.0001) in the study group, elucidating the cause of whiplash injury. The Neck Disability Index was <24 points, indicating only mild-to-moderate disability in these patients. Whiplash injury incidence in this study (13%) was similar to the incidence of neck pain in the general population.

CONCLUSIONS

The incidence of whiplash injury following polytrauma was found to be low in our study. There is no dose-response relation between magnitude of trauma severity and incidence of whiplash injury.