PT  - JOURNAL ARTICLE
AU  - Gwenllian Wynne-Jones
AU  - Gareth T Jones
AU  - Nicola J Wiles
AU  - Alan J Silman
AU  - Gary J Macfarlane
TI  - Predicting new onset of widespread pain following a motor vehicle collision.
DP  - 2006 May 01
TA  - The Journal of Rheumatology
PG  - 968--974
VI  - 33
IP  - 5
4099  - http://www.jrheum.org/content/33/5/968.short
4100  - http://www.jrheum.org/content/33/5/968.full
SO  - J Rheumatol2006 May 01; 33
AB  - 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.