Abstract
BACKGROUND: In a setting with a 'no fault' universal government-funded accident compensation system, we undertook a study to (i) estimate the prevalence and predictors of chronic neck pain in car occupants surviving serious injury-producing crashes and (ii) compare the longer-term health-related quality of life of crash survivors with and without neck discomfort. METHODS: A prospective cohort study recruited hospitalized survivors aged ≥ 16 years and non-hospitalized drivers of cars involved in serious crashes in Auckland over a 10-month period. Participants completed a structured questionnaire at recruitment and 5 and 18 months later. RESULTS: Of the 268 participants, 50 (18.7%) reported neck pain or stiffness at 5 and 18 months following the crash. Of these, 70% noted the discomfort led to limitations in work and recreation. Depressive and post-traumatic stress symptoms at 5 months were associated with an increased risk of moderate to severe neck discomfort at 18 months. Participants with and without neck discomfort had significantly reduced health-related quality of life based on Short Form-36 scores. CONCLUSION: Significant neck discomfort limiting usual function is relatively common up to 18 months following crashes. The reductions in health status among crash survivors with and without neck pain reveal the complexities in attributing longer-term adverse outcomes to a particular condition in the absence of an appropriate comparison group. The findings indicate the need to manage judiciously comorbid conditions while prioritizing efforts to support crash survivors' return to their usual social roles and activities. [Author Abstract] KEY WORDS: neck pain; whiplash-associated disorders; health outcomes; cohort study; prognosis; motor vehicle crashes