| 1. |
- Styrke, Johan, 1980-, et al.
(författare)
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A 10-year incidence of acute whiplash injuries after road traffic crashes in a defined population in Northern Sweden
- 2012
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Ingår i: PM&R. - New York, NY, USA : Elsevier. - 1934-1482 .- 1934-1563. ; 4:10, s. 739-747
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo examine the annual incidence of acute whiplash injuries after road traffic crashes in a geographic catchment area in Northern Sweden during the period 2000-2009.DesignDescriptive epidemiology determined by prospectively collected data from a defined population.SettingThe study was conducted at a public hospital in Sweden.ParticipantsThe population of the hospital's catchment area (136,600 inhabitants in 1999 and 144,500 in 2009).MethodsAt the emergency department, all injured persons (approximately 11,000 per year) were asked to answer a questionnaire about the injury incident. Data from the medical records also were analyzed. From 2000-2009, 15,506 persons were injured in vehicle crashes. Persons who were subject to an acute neck injury within whiplash-associated disorder grades 1-3 were included. The overall and annual incidences were calculated as incidence. Age, gender, type of injury event, and direction of impact were described. The incidences were compared with national statistics on insurance claims from 2003, 2007, and 2008 to detect changes in the proportions of claims.Main Outcome MeasuresThe annual incidence of acute whiplash injuries. Secondary outcome measures were types of injury events, age and gender distribution, changes in the proportion of rear-end crashes during 2000-2009, and changes in the proportion of insurance claims during 2003-2008.ResultsDuring 2000-2009, 3297 cases of acute whiplash injury were encountered. The overall incidence was 235/100,000/year. The average yearly increase in incidence was 1.0%. Women comprised 51.9% and men 48.1% of the injured. Car occupants (86.4%) and bicycle riders (6.1%) were most frequently injured. The proportion of rear-end crashes decreased from 55% to 45% from 2000-2009. The proportion of insurance claims significantly decreased between 2003 and 2008 (P < .0001, χ2 test).ConclusionThe incidence of emergency department visits attributable to acute whiplash injuries after road traffic crashes have been relatively stable during the past decade in our area, except in 2007 and 2008, when a peak occurred.
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| 2. |
- Styrke, Johan, 1980-, et al.
(författare)
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Sex-differences in symptoms, disability, and life satisfaction three years after mild traumatic brain injury : a population-based cohort study
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 45:8, s. 749-757
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate sex differences in symptoms, structure of symptoms, disability and life satisfaction 3 years after mild traumatic brain injury. Secondary aims were to find risk factors for adverse outcome.DESIGN: Population-based cohort study.Patients: The cohort comprised 137,000 inhabitants at risk in a defined population served by a single hospital in northern Sweden. Patients attending the emergency department following a mild traumatic brain injury in 2001 were included.METHODS: Of 214 patients aged 18–64 years, 163 answered a questionnaire on symptoms, disability, and life-satisfaction 3 years post-injury. The instruments were analysed with descriptive statistics. A principal component analysis of the Rivermead Post-Concussion Symptoms Questionnaire was conducted. Risk factors were identified using logistic regression.RESULTS: Post-concussion syndrome was found in 50% of the women and 30% of the men. Disability was found in 52% of the women and 37% of the men, and 57% of the women and 56% of the men were satisfied with their lives. For both genders, high frequency of symptoms was a risk factor for disability and low life satisfaction. Back pain was a risk factor for disability. Living alone was a risk factor for low levels of life satisfaction. The principal component analysis revealed differences between the sexes.CONCLUSION: There are sex differences in outcome 3 years after mild traumatic brain injury. Women and men should be analysed separately.
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| 3. |
- Styrke, Johan, 1980-, et al.
(författare)
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Symptoms, disability, and life satisfaction five years after whiplash injuries
- 2014
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; , s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic whiplash-associated disorders (WADs) are often associated with social functioning problems and decreased ability to perform previous activities. This may lead to decreased life satisfaction, which is insufficiently studied in the context of whiplash injuries. Symptoms included in chronic WAD are similar to symptoms frequently reported by persons who have sustained mild traumatic brain injury (MTBI)/concussion. In cases of MTBI, the severity and number of symptoms have been suggested to have a diagnostic value. The corresponding importance of symptoms in chronic WAD has not been documented. Most studies of whiplash injuries have focused on neck pain because this is the dominant complaint, while other symptoms are less studied. The frequency of long-term symptoms after whiplash injuries seems to vary. It is difficult to compare the long-term outcome since the follow-up after whiplash injury in most studies has been rather short. Therefore, the primary aim of this investigation was to study neck pain and other symptoms, disability, and life satisfaction five years after whiplash injury in a defined population and geographical area.Methods: The study was carried out at a public hospital in northern Sweden and was a cross-sectional survey of patients five years after the injury event in a cohort of whiplash-injured patients. Five years after the emergency department visit, 186 persons aged 18–64 answered questionnaires on symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), disabilities (Rivermead Head Injury Follow Up Questionnaire, RHFUQ), and life satisfaction (LiSat-11). The answers were compared to those of a comparison cohort.Results: The most common symptoms five years after whiplash injury were fatigue (41%), poor memory (39%), and headache (37%). Inability to sustain previous workload (44%) and fatigue at work (43%) were frequently reported disabilities. Only 39% were satisfied with their somatic health and 60% with their psychological health. Compared with healthy controls, the whiplash injured exhibited more symptoms and had lower life satisfaction. Women reported significantly higher pain intensity than men. Few significant differences between women and men regarding the other parameters were found.Conclusions: This study shows that five years after a whiplash injury, patients reported symptoms that are typical of mild traumatic brain injury. Further, this study emphasizes the possibility of screening patients with chronic WAD for these symptoms as a complement to the assessment.Implications: Untreated symptoms may negatively affect the outcome of pain rehabilitation. This implies that it might be clinically meaningful to quantify symptoms earlier in the rehabilitation process
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| 4. |
- Styrke, Johan, 1980-
(författare)
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Traumatic brain injuries and whiplash injuries : epidemiology and long-term consequences
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThe incidence of traumatic brain injuries (TBI) is about 500 cases per 100,000 inhabitants per year, a majority of which are mild TBI (MTBI). The incidence of whiplash injuries is about 300/100,000/year. There are several similarities between MTBI and whiplash injuries with regard to the causes of injury (traffic crashes and falls), the demographic profile of the injured (mostly young persons), and the type of symptoms exhibited by some of the injured (for example head/neck pain, fatigue, irritability, impaired cognitive functioning, and depression). Main aimTo investigate the epidemiology and long-term consequences in terms of symptoms, disability, and life satisfaction in cases of TBI and whiplash injuries in a well-defined population.Material and methodsData on frequencies and characteristics of TBI and whiplash injuries were extracted from the injury database at the emergency department (ED) of Umeå University Hospital (UUH). The results were presented as descriptive epidemiology.The 18-65 year-old persons who sustained an MTBI or whiplash injury in 2001, were provided a questionnaire three and five years after injury respectively, in which questions were asked about:Symptoms; Rivermead Post Concussion Symptoms Questionnaire (RPQ) Disability; Rivermead Head Injury Follow Up Questionnaire (RHFUQ)Life satisfaction; LiSat-11A local reference population was used for comparison of the RPQ. A national cohort was used as reference for LiSat-11. Data on sick leave for the cases of whiplash injuries were analysed to calculate the cost to society for loss of productivity.ResultsIn 2001, the incidence of TBI was 354/100,000/year. The mean age was 23 and 55% were men. Ninety-seven percent of the injuries were classified as mild (Glasgow coma scale 13-15). The main causes were falls (55%) and traffic related injury events (30%). In 8% of the cases (17% of the elderly persons) an intracranial bleeding was detected by using CT.The 3-year follow-up of the MTBI patients showed that women had more symptoms and disability (~50%) than men (~30%). Both women and men had more symptoms and lower life satisfaction compared with the reference population.The incidence of traffic-related whiplash injuries in adults was 235/100,000/year and the annual incidences were relatively stable during 2000-2009. Combining the incidences with national insurance data showed that the proportion of insurance claims decreased during the period.When looking at whiplash trauma following all causes of injury in 2001, traffic crashes caused 61% of the injuries and falls caused 14%. Neck fractures occurred in 3% of the cases.Five years after whiplash injury, the injured persons had more symptoms and lower life satisfaction than the references. Sick leave ≥15 days was granted in 14% of the cases of whiplash injuries. The median number of sick days was 298 and the cost of loss of productivity during the follow-up was 5.6 million USD.The frequencies of symptoms were relatively alike when comparing subjects with whiplash injuries to subjects with MTBI.ConclusionTBI and whiplash injuries are common, especially among young people, and the injuries render long-term symptoms, disability, and impaired life satisfaction in up to 50% of the cases. Symptoms exhibited are alike between the two types of injuries. The cost to society for loss of productivity is high, and there is a need for enhanced preventive measures aiming at reducing traffic-related injuries, sports injuries, alcohol-related injuries, and falls. Physical, mental, and social factors are important and should be addressed when examining and treating patients with persisting symptoms following TBI and whiplash injuries.
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| 5. |
- Styrke, Johan, 1980-, et al.
(författare)
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Traumatic brain injuries in a well-defined population : epidemiological aspects and severity
- 2007
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Ingår i: Journal of Neurotrauma. - New York, NY, USA : Mary Ann Liebert, Inc.. - 0897-7151 .- 1557-9042. ; 24:9, s. 1425-1436
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe epidemiological and medical aspects of 449 cases of traumatic brain injury (TBI) from a well-defined geographical area with a population of 137,000 inhabitants. An episode of disturbed consciousness was a prerequisite for inclusion in the study. The incidence of TBI was 354/100,000 inhabitants. Median age was 23 years, range 0–91 years; 55% were men and 45% were women; 33% children 0–14 years, 50% adults 15–64 years, and 17% elderly persons 65–91 years old. Severity classification was based on Glasgow Coma Scale (GCS) on arrival; mild TBI 97% (GCS 13–15), moderate 1% (GCS 9–12), and severe 2% (GCS 3–8). The most common injury events were falls (55%) and vehicle-related events (30%). The percentage of falls was high among children and elderly persons but among adults vehicle-related injury events were also prominent. At least 17% of all patients were under the influence of alcohol, especially adult male bicyclists. CT was performed on 163 cases (36%) revealing 34 cases with intracranial hemorrhage (ICH) which is 21% of the examined or 8% of all the injured. The rate of ICH increased with increasing age (from 3% among children to 17% among the elderly persons) and also increased with decreasing GCS from 6% in the group of mild TBI to 60% among those with severe TBI. Attention should be directed to acute management of mild TBI in order to detect potentially dangerous ICH as well as to preventive actions against falls and vehicle related accidents.
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| 6. |
- Styrke, Johan, 1980-, et al.
(författare)
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Whiplash trauma : epidemiology, long-term sick leave and its' costs
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Neck injuries following whiplash trauma are common and primarily caused by traffic incidents but are also caused by fall incidents and sporting mishaps. The economic consequences to society for the consequent sick leave are significant. Original studies covering all types of cervical spine injuries (WAD-grade 1-4) following whiplash trauma and the following sick leave are rare. The aim of this study was to describe the epidemiology of neck injuries caused by whiplash trauma and the resulting long-term sick leave of patients in a well-defined area who sought medical attention within a one-year period and with a five-year follow-up. Possible risk factors for sick leave and the cost of loss of productivity were also studied.Materials and Methods: From the ongoing injury registration of Umeå University Hospital, the only hospital in the area, we extracted the year 2001’s data set of neck injuries (acute WAD 1-4). Those injured by whiplash trauma were included. The Swedish Social Insurance Agency provided five-year post-injury data on sick leave because of the injury in question. This is a compulsory register of all Swedes. Epidemiological aspects were described and follow-up data were analysed to find risk factors for long-term sick leave.Results: The incidence was 383/100,000/year for all ages. In 14% of 18-64 year olds, sick leave was granted for more than two weeks and the median number of sick days in this group was 298. Older age, having a WAD-grade of 1, being injured in traffic crashes and being injured at velocity exceeding 50 km/h were significant risk factors for being granted sick leave. A few (6%) had more serious cervical spine injuries (WAD 4). However, their average time on sick leave was not significantly longer than the sick leave of those with WAD 1-3. The cost to society for loss of productivity was estimated at 5.6 million USD during the 5-year follow-up.Conclusion: Whiplash injuries affect many people including the young. The long-term periods of sick leave described in this paper indicate individual suffering as well as a societal economic burden. Finding preventive measures is of most importance.
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| 7. |
- Åhman, Sara, et al.
(författare)
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Long-term follow-up of patients with mild traumatic brain injury : a mixed-methods study
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 45:8, s. 758-764
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterize the long-term consequences of mild traumatic brain injury regarding post-concussion symptoms, post-traumatic stress, and quality of life; and to investigate differences between men and women.DESIGN: Retrospective mixed-methods study.Subjects/patients and methods: Of 214 patients with mild traumatic brain injury seeking acute care, 163 answered questionnaires concerning post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire; RPQ), post-traumatic stress (Impact of Event Scale; IES), and quality of life (Short Form Health Survey; SF-36) 3 years post-injury. A total of 21 patients underwent a medical examination in connection with the survey. The patients were contacted 11 years later, and 10 were interviewed. Interview data were analysed with content analysis.RESULTS: The mean total RPQ score was 12.7 (standard deviation; SD 12.9); 10.5 (SD 11.9) for men and 15.9 (SD 13.8) for women (p = 0.006). The 5 most common symptoms were fatigue (53.4%), poor memory (52.5%), headache (50.9%), frustration (47.9%) and depression (47.2%). The mean total IES score was 9.6 (SD 12.9) 7.1 (SD 10.3) for men and 13.0 (SD 15.2) for women (p = 0.004). In general, the studied population had low scores on the Short Form Health Survey (SF-36). The interviews revealed that some patients still had disabling post-concussion symptoms and consequences in many areas of life 11 years after the injury event.CONCLUSION: Long-term consequences were present for approximately 50% of the patients 3 years after mild traumatic brain injury and were also reported 11 years after mild traumatic brain injury. This needs to be taken into account by healthcare professionals and society in general when dealing with people who have undergone mild traumatic brain injury.
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