Citation

Littleton SM, Hughes DC, Poustie SJ, Robinson BJ, Neeman T, Smith PN, Cameron ID. Injury 2012; 43(9): 1586-1592.

Affiliation

College of Medicine, Biology and Environment, Australian National University, Australia.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.injury.2011.03.002

PMID

21453916

Abstract

OBJECTIVE: To compare the early health status of people who sustained injuries during road traffic crashes (RTC) in which they were at fault (AF), with people who sustained injuries in RTC in which they were not at fault (NAF). DESIGN: Prospective cohort study. SUBJECTS: People presenting to the emergency department with mild to moderate musculoskeletal injuries following RTC. MAIN OUTCOME MEASURES: Physical Component Score (PCS) and Mental Component Score (MCS) of the Short Form 36 (SF-36) health status measure; Hospital Anxiety and Depression Scale (HADS) and the Functional Rating Index (FRI) recorded immediately post-crash. RESULTS: 193 people participated in the study and were enrolled a mean of 9.3days following the crash. The mean age was 37years and 60% were female. 71% were NAF. There was a significantly higher number of females in the NAF group (65% compared with 35% males; p<0.001). Neck and back injuries were reported by 90.4% of the NAF group compared to 69.1% of the AF group (p<0.001). There were no significant differences in PCS, FRI or pain intensity between the two groups at a mean of 9.3days after the crash. The mean MCS for the NAF group was significantly worse than for the AF group (31.4 compared to 37.3; p=0.005). The SF-36 domain revealed a significantly worse adjusted mean role emotional score for the NAF group (23.4 compared to 32.5, p=0.002). Females had significantly worse MCS score than males (30.6 and 38.1 respectively; p<0.001) and worse adjusted mean anxiety and depression scores (10 compared to 7.8; p=0.002 and 7.6 compared to 5.5; p=0.002 respectively). CONCLUSIONS: Despite there being no difference in physical health status, the NAF group demonstrated more emotional and mental disturbance than the AF group; and this was significantly worse for females. Treatment strategies should focus on addressing early pain and disability as well as providing appropriate psychological interventions, particularly for people not at fault following RTC.

Language: en