Hours Martine, Khati Inès, Charnay Pierrette, Chossegros Laetitia, Tardy Hélène, Tournier Charlène, Perrine Anne-Laure, Luauté Jacques, Laumon Bernard
From the Unité Mixte de Recherche épidémiologique et de surveillance Transport Travail Environnement (UMRESTTE), Lyon; IFSTTAR, Bron; Lyon University, Lyon; Henry Gabrielle Hospital, Saint Genis-Laval; Institut National de Veille Sanitaire, Maladies Chroniques, St. Maurice, France.
J Rheumatol. 2014 Mar;41(3):528-38. doi: 10.3899/jrheum.130406. Epub 2013 Dec 15.
To compare health status, effect on family, occupational consequences, and quality of life (QOL) 1 year after an accident between patients with whiplash versus other mild injuries, and to explore the relationship between initial injury (whiplash vs other) and QOL.
This was a prospective cohort study. The study used data from the ESPARR cohort (a representative cohort of road accident victims) and included 173 individuals with "pure" whiplash and 207 with other mild injuries. QOL at 1-year followup was assessed on the World Health Organization Quality of Life questionnaire. Correlations between explanatory variables and QOL were explored by Poisson regression to provide adjusted relative risks, with ANOVA for the various QOL scores explored.
One year post-accident, more patients who had whiplash than other casualties complained of nonrecovery of health status (56% vs 43%) and of the occupational effect of pain (31% vs 23%). QOL and posttraumatic stress disorder (PTSD) were similar in the 2 groups. Impaired QOL did not correlate with whiplash when models were adjusted on sociodemographic variables and history of psychological distress. Whatever the initial lesion, PTSD was a determining factor for poorer QOL.
Sociodemographic factors, preaccident psychological history prior to the accident, and PTSD were the main factors influencing QOL, rather than whether the injury was whiplash. PTSD may also be related to pain.
比较挥鞭样损伤患者与其他轻度损伤患者在事故发生1年后的健康状况、对家庭的影响、职业后果及生活质量(QOL),并探讨初始损伤(挥鞭样损伤与其他损伤)与生活质量之间的关系。
这是一项前瞻性队列研究。该研究使用了ESPARR队列(道路交通事故受害者的代表性队列)的数据,纳入了173例“单纯”挥鞭样损伤患者和207例其他轻度损伤患者。采用世界卫生组织生活质量问卷对1年随访时的生活质量进行评估。通过泊松回归探索解释变量与生活质量之间的相关性,以提供调整后的相对风险,并对各种生活质量得分进行方差分析。
事故发生1年后,与其他伤者相比,更多的挥鞭样损伤患者抱怨健康状况未恢复(56%对43%)以及疼痛对职业的影响(31%对23%)。两组的生活质量和创伤后应激障碍(PTSD)相似。在对社会人口统计学变量和心理困扰史进行调整后,生活质量受损与挥鞭样损伤无关。无论初始损伤如何,创伤后应激障碍都是生活质量较差的决定因素。
社会人口统计学因素、事故前的心理病史以及创伤后应激障碍是影响生活质量的主要因素,而非损伤是否为挥鞭样损伤。创伤后应激障碍也可能与疼痛有关。