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Histoire naturelle de la douleur à la phase aiguë des traumatismes cervicaux pris en charge aux urgences : étude TraCeMED

Natural history of pain after whiplash injury at the acute phase: TraCeMED study

  • Article Original / Original Article
  • Published:
Annales françaises de médecine d'urgence

Résumé

Objectif

Décrire l’évolution de la douleur dans les sept jours qui suivent un traumatisme bénin du rachis cervical.

Matériel et méthode

Entre juillet 2011 et juin 2012, nous avons réalisé une étude prospective observationnelle. Les patients inclus présentaient un traumatisme du rachis cervical datant de moins de 48 heures, sans critère clinique ou radiologique de lésion grave. Une échelle numérique évaluait la douleur de ces patients. Les données étaient recueillies à la consultation initiale, puis par téléphone à j2, j5 et j7.

Résultats

Vingt-neuf patients répondaient aux critères d’inclusion et de suivi téléphonique. La moyenne des valeurs de l’échelle numérique de la douleur était de 5,3/10 à la consultation initiale, 4,4/10 à j2, 2,6/10 à j5 et 1,4/10 à j7. La diminution de la douleur entre chaque consultation était statistiquement significative (p < 0,05). La proportion de patients dont la douleur était strictement inférieure à 3/10 était de 10 % à la consultation initiale (n = 3), puis 21 % (n = 6) à j2, 55 % (n = 16) à j5 et 76 % (n = 22) à j7.

Conclusion

La diminution de la douleur dans la première semaine qui suit un traumatisme du rachis cervical est suffisamment importante pour permettre la réalisation de clichés dynamiques plus précoce. Des études ultérieures permettraient de compléter ces résultats pour permettre une diminution des arrêts de travail et donc du coût pour la société.

Abstract

Aim

Describe the evolution of pain within 7 days after a whiplash injury.

Procedure

From July 2011 to June 2012, we carried out a prospective observational study. Patients involved in this study had a whiplash injury less than 48 hours, without any clinical or radiological criteria of serious injury. A numerical scale was used to assess the pain of these patients. The data were collected at the first consultation, later by phone on the 2nd, 5th and 7th days and finally at the final consultation of orthopaedic surgery.

Results

Twenty-nine patients met the inclusion and followup criteria. The average value of the numerical scale of pain was 5.3/10 at the emergency consultation, 4.4/10 after 2 days, 2.6/10 after 5 days and 1.4/10 after 7 days. The pain reduction between each consultation was statistically significant (P < 0.05). The proportion of patients whose pain was assessed at less than 3/10 was 10% (N = 3) at the emergency consultation, 21% (N = 6) after 2 days, 55% (N = 16) after 5 days and 76% (N = 22) after 7 days.

Conclusion

Pain reduction in the first week after a whiplash injury is good enough to make the dynamic X-rays earlier. Further studies would complement these results to allow a reduction in work stoppages and, therefore, the cost for the society.

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Authors and Affiliations

  1. Service d’accueil des urgences, CHU de Poitiers, 2, rue de la Milétrie, F-86021, Poitiers, France

    G. Versmée, O. Bineau, F. Rayeh, Y. Guechi, C. Delaire, J. -Y. Lardeur & M. Scépi

  2. Épidémiologie et biostatistique, Inserm CIC 0802, CHU de Poitiers, Poitiers, France

    P. Ingrand

  3. Université de Poitiers, 6, rue de la Miletrie, F-86034, Poitiers, France

    P. Ingrand & M. Scépi

Authors
  1. G. Versmée
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  2. O. Bineau
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  3. F. Rayeh
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  4. P. Ingrand
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  5. Y. Guechi
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  6. C. Delaire
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  7. J. -Y. Lardeur
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  8. M. Scépi
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Correspondence to G. Versmée.

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Versmée, G., Bineau, O., Rayeh, F. et al. Histoire naturelle de la douleur à la phase aiguë des traumatismes cervicaux pris en charge aux urgences : étude TraCeMED. Ann. Fr. Med. Urgence 3, 280–285 (2013). https://doi.org/10.1007/s13341-013-0341-y

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  • DOI: https://doi.org/10.1007/s13341-013-0341-y

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