College of Medicine, Biology and Environment, Australian National University, Australia.
Injury. 2012 Sep;43(9):1586-92. doi: 10.1016/j.injury.2011.03.002. Epub 2011 Mar 31.
To compare the early health status of people who sustained injuries during road traffic crashes (RTC) in which they were at fault (AF), with people who sustained injuries in RTC in which they were not at fault (NAF).
Prospective cohort study.
People presenting to the emergency department with mild to moderate musculoskeletal injuries following RTC.
Physical Component Score (PCS) and Mental Component Score (MCS) of the Short Form 36 (SF-36) health status measure; Hospital Anxiety and Depression Scale (HADS) and the Functional Rating Index (FRI) recorded immediately post-crash.
193 people participated in the study and were enrolled a mean of 9.3 days following the crash. The mean age was 37 years and 60% were female. 71% were NAF. There was a significantly higher number of females in the NAF group (65% compared with 35% males; p<0.001). Neck and back injuries were reported by 90.4% of the NAF group compared to 69.1% of the AF group (p<0.001). There were no significant differences in PCS, FRI or pain intensity between the two groups at a mean of 9.3 days after the crash. The mean MCS for the NAF group was significantly worse than for the AF group (31.4 compared to 37.3; p = 0.005). The SF-36 domain revealed a significantly worse adjusted mean role emotional score for the NAF group (23.4 compared to 32.5, p = 0.002). Females had significantly worse MCS score than males (30.6 and 38.1 respectively; p<0.001) and worse adjusted mean anxiety and depression scores (10 compared to 7.8; p = 0.002 and 7.6 compared to 5.5; p = 0.002 respectively).
Despite there being no difference in physical health status, the NAF group demonstrated more emotional and mental disturbance than the AF group; and this was significantly worse for females. Treatment strategies should focus on addressing early pain and disability as well as providing appropriate psychological interventions, particularly for people not at fault following RTC.
比较在道路交通事故（RTC）中负有责任（AF）和无责任（NAF）的受伤人群的早期健康状况。
前瞻性队列研究。
RTC 导致的轻度至中度肌肉骨骼损伤后到急诊科就诊的人群。
健康状况衡量标准（SF-36）的生理功能评分（PCS）和精神健康评分（MCS）、车祸后即刻记录的医院焦虑抑郁量表（HADS）和功能评定指数（FRI）。
193 名参与者参与了该研究，平均在事故发生后 9.3 天入组。平均年龄为 37 岁，60%为女性。71%为 NAF。在 NAF 组中，女性比例明显更高（65%比男性 35%；p<0.001）。与 AF 组（69.1%）相比，NAF 组报告颈部和背部受伤的比例更高（90.4%；p<0.001）。在事故发生后 9.3 天，两组的 PCS、FRI 或疼痛强度无显著差异。与 AF 组相比，NAF 组的 MCS 明显更差（31.4 比 37.3；p = 0.005）。SF-36 域显示，NAF 组的角色情绪评分明显更差（23.4 比 32.5，p = 0.002）。女性的 MCS 评分明显低于男性（分别为 30.6 和 38.1；p<0.001），焦虑和抑郁评分的调整均值也明显更高（10 分比 7.8 分；p = 0.002 和 7.6 分比 5.5 分；p = 0.002）。
尽管在身体健康状况方面没有差异，但 NAF 组比 AF 组表现出更多的情绪和心理困扰；女性的情况更为严重。治疗策略应侧重于解决早期疼痛和残疾问题，并提供适当的心理干预，尤其是针对 RTC 无责任的人群。
