Johansson M S, Boyle E, Hartvigsen J, Jensen Stochkendahl M, Carroll L, Cassidy J D
Department of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, ON, Canada.
Eur J Pain. 2015 Nov;19(10):1486-95. doi: 10.1002/ejp.681. Epub 2015 Feb 17.
Traffic collisions often result in a wide range of symptoms included in the umbrella term whiplash-associated disorders. Mid-back pain (MBP) is one of these symptoms. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain, depression or others) has been investigated previously; however, knowledge about traffic collision-related MBP is lacking. The study objectives were to describe the incidence, course of recovery and prognosis of MBP after traffic collisions, in terms of global self-reported recovery.
Longitudinal data from a population-based inception cohort of all traffic injuries occurring in Saskatchewan, Canada, during a 2-year period were used. Annual overall and age-sex-specific incidence rates were calculated, the course of recovery was described using the Kaplan-Meier technique, and associations between participant characteristics and time-to-self-reported recovery were explored in 3496 MBP cases using Cox proportional hazards models.
The yearly incidence rate was 236 per 100,000 population during the study period, and was highest in women and in young persons. The median time-to-first reported recovery was 101 days (95% CI: 99-104) and about 23% were still not recovered after 1 year. Participant's expectation for recovery, general health, extent of severely affecting comorbidities and having experienced a previous traffic injury were some of the prognostic factors identified.
These findings show that MBP is common after traffic collisions, may result in a long recovery process and that a range of biopsychosocial factors are associated with recovery.
交通碰撞常常导致一系列症状,这些症状都包含在“挥鞭样相关障碍”这一统称之中。中背部疼痛(MBP)就是其中一种症状。此前已经对不同交通伤及其相关状况(如颈部疼痛、下背部疼痛、抑郁或其他症状)的发病率和预后进行了调查;然而,关于与交通碰撞相关的中背部疼痛的知识却很匮乏。本研究的目的是从整体自我报告的康复情况方面,描述交通碰撞后中背部疼痛的发病率、康复过程和预后。
使用了来自加拿大萨斯喀彻温省在两年期间内发生的所有交通伤的基于人群的起始队列的纵向数据。计算了年度总体发病率以及年龄和性别特异性发病率,使用Kaplan-Meier技术描述康复过程,并使用Cox比例风险模型在3496例中背部疼痛病例中探索参与者特征与自我报告康复时间之间的关联。
在研究期间,年发病率为每10万人236例,女性和年轻人的发病率最高。首次报告康复的中位时间为101天(95%置信区间:99 - 104),1年后仍有大约23%未康复。确定的一些预后因素包括参与者对康复的期望、总体健康状况、严重影响合并症的程度以及曾经历过交通伤。
这些研究结果表明,交通碰撞后中背部疼痛很常见,可能导致漫长的康复过程,并且一系列生物心理社会因素与康复有关。