Yamashita Yuh, Kogo Haruki, Inoue Tadatoshi, Higashi Toshio
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN.
Department of Rehabilitation, Morinaga Orthopedic Clinic, Saga, JPN.
Cureus. 2024 Aug 8;16(8):e66435. doi: 10.7759/cureus.66435. eCollection 2024 Aug.
Background Whiplash-associated disorders are sequelae of traffic accidents that frequently result in sustained pain and disability due to a broader spectrum of symptoms than typical neck pain. Several studies have used the length of time from injury to the completion of insurance claims as a measure of recovery time for patients with whiplash-associated disorders. However, studies on the initial factors in patients whose treatment exceeds 90 days are lacking. Therefore, this study aimed to identify key factors predicting prolonged treatment duration in Japanese patients with whiplash-associated disorders. Methodology We included 103 outpatients who presented with neck pain after a motor vehicle accident. During their initial visits, various factors were comprehensively assessed, including pain intensity, Neck Disability Index (NDI), six items of the Pain Catastrophizing Scale (PCS-6), a short version of the Tampa Scale of Kinesiophobia, the Injustice Experience Questionnaire, cervical range of motion, and radiographic findings. Patients were categorized into "early recovery" or "delayed recovery" groups based on the time elapsed between the first assessment and the end of the treatment period. Logistic regression analysis identified cut-off values from receiver operating characteristic curves to help identify factors contributing to delays in the recovery process. Results Analysis showed that initial NDI and PCS-6 scores of ≥35% and ≥12, respectively, were significant predictors of delayed recovery, increasing the odds of delay by factors of 3.19 and 4.46, respectively. Conclusions Our findings may aid in appropriate clinical decision-making and lead to interventions to minimize the negative impact of prolonged treatment duration on patient recovery.
背景 挥鞭样损伤相关疾病是交通事故的后遗症，由于其症状范围比典型的颈部疼痛更广，常导致持续性疼痛和残疾。多项研究将从受伤到保险理赔完成的时间长度作为挥鞭样损伤相关疾病患者恢复时间的一项衡量指标。然而，对于治疗时间超过90天的患者的初始因素研究尚缺。因此，本研究旨在确定预测日本挥鞭样损伤相关疾病患者治疗时间延长的关键因素。方法 我们纳入了103例机动车事故后出现颈部疼痛的门诊患者。在他们首次就诊时，对各种因素进行了全面评估，包括疼痛强度、颈部残疾指数（NDI）、疼痛灾难化量表（PCS-6）的六个项目、坦帕运动恐惧量表简版、不公正经历问卷、颈椎活动范围和影像学检查结果。根据首次评估到治疗期结束之间的时间，将患者分为“早期恢复”或“延迟恢复”组。逻辑回归分析从受试者工作特征曲线确定临界值，以帮助识别导致恢复过程延迟的因素。结果 分析表明，初始NDI和PCS-6评分分别≥35%和≥12是延迟恢复的显著预测因素，延迟几率分别增加3.19倍和4.46倍。结论 我们的研究结果可能有助于进行适当的临床决策，并促成相关干预措施，以尽量减少治疗时间延长对患者恢复的负面影响。
