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OBJECTIVE: To determine, in a group of persons involved in a motor vehicle collision, the contributions of pre-collision health and psychological factors, the social environment, collision-specific factors, and post-collision symptoms, to the new onset of widespread pain (WP). METHODS: A prospective cohort study of persons, registered with an insurance company, who had recently experienced a motor vehicle collision. Participants were sent a questionnaire to assess pre-collision health, collision-specific factors, post-collision health, and WP. Those reporting WP prior to the collision were excluded from followup. At 12 months, participants were sent a followup questionnaire to ascertain one-month period prevalence of (new onset) WP. RESULTS: In total 957 individuals took part in the baseline survey and were eligible for followup. Subsequently, 695 (73%) completed a questionnaire at 12 months, of whom 54 (7.8%) reported new WP. Few collision-specific factors predicted the onset of WP. In contrast, post-collision physical symptoms (rate ratio 2.5, 95% confidence interval 1.2-5.1), pre-collision health-seeking behavior (RR 3.6, 95% CI 1.6-7.9), pre-collision somatization (RR 1.7, 95% CI 0.99-2.8), and perceived initial injury severity (RR 1.7, 95% CI 0.9-3.3), in addition to older age (RR 3.3, 95% CI 1.5-7.1), were all independently predictive of new onset WP. In combination, these factors accounted for about a 20-fold difference in the risk of new onset WP. CONCLUSION: We identified 5 factors that independently predict the onset of WP following a motor vehicle collision. Early identification of this "at-risk" group may allow the targeting of preventive management in those at highest risk of developing future symptoms.

Type

Journal article

Journal

The Journal of rheumatology

Publication Date

05/2006

Volume

33

Pages

968 - 974

Addresses

Primary Care Sciences Research Centre, Keele University, Keele, United Kingdom.

Keywords

Musculoskeletal System, Humans, Pain, Neck Pain, Chronic Disease, Questionnaires, Injury Severity Score, Multivariate Analysis, Confidence Intervals, Risk Factors, Cohort Studies, Prospective Studies, Stress, Psychological, Accidents, Traffic, Automobile Driving, Adolescent, Adult, Aged, Middle Aged, Patient Care Management, Female, Male