Whiplash following rear end collisions: a prospective cohort study

Objective: The purpose of this study was to investigate the factors which predict neck pain initially and at 1 year following a rear end collision. Methods: All people who reported a rear end collision to the Devon and Cornwall Constabulary were identified and formed the basis of the cohort. People were excluded if they were under 18 years of age or had suffered a head injury. The main outcome measures were neck pain lasting for more than a week after the accident and neck pain at least 1 day a week at 1 year. Logistic regression was used to investigate associations between demographic and accident related variables and outcomes. Results: A total of 1147 people reported rear end collisions to the police during the study period and 503 (44%) agreed to take part in the study. Of the respondents, 78% had neck pain lasting for more than a week and 52% still had pain at 1 year. Age ( odds ratio, 95% confidence interval: 0.957, 0.942 - 0.972) and prior history of neck pain ( 8.32, 2.89 - 23.89) were the most important predictors of early neck pain. The most important predictors of pain at 1 year were the initial neck visual analogue scale ( VAS) score (1.03, 1.01 - 1.05) and the presence of a compensation claim (4.09, 1.62 - 10.32). There was only weak evidence that measures of the severity of the impact were associated with outcomes. Conclusion: Demographic variables and the presence of a compensation suit show the strongest correlation with acute and chronic neck pain following rear end collisions.