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Quality of life and functional outcome after pediatric trauma
Andrea L Winthrop1, Karen J Brasel, Linda Stahovic
1Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. winthrop@mcw.edu
Insights
Pediatric trauma significantly impacts children and families. While function and quality of life improve rapidly after blunt injury, physical scores remain below norms at six months.
Area of Science:
- Pediatric Traumatology
- Rehabilitation Medicine
- Child Health Outcomes
Background:
- Childhood injuries are a leading cause of preventable disability.
- Assessing long-term sequelae requires measuring impairment post-trauma.
- Pediatric trauma significantly impacts families.
Purpose of the Study:
- To evaluate the quality of life and functional status of pediatric trauma patients.
- To track outcomes at hospital discharge and 1, 6, and 12 months post-injury.
- To understand the impact of injury on children and their families.
Main Methods:
- Prospective longitudinal study of children (1-18 years) with blunt injury (Injury Severity Score >/= 9).
- Exclusion of head and spinal cord injuries.
- Utilized Child Health Questionnaire (CHQ), Functional Independence Measure (FIM), and Impact on Family Scale (IOFS) at specified intervals.
Main Results:
- 162 children enrolled; 156 completed 6-month follow-up.
- Motor vehicle accidents were the most common cause (43%).
- Significant improvements in CHQ and FIM scores from baseline to 6 months, but physical scores remained below age-matched norms.
Conclusions:
- Pediatric blunt injury imposes a substantial burden on families.
- Children show rapid functional and quality of life recovery post-injury.
- Persistent lower physical function at 6 months warrants further investigation for long-term recovery potential.
Background:
Injury is the leading cause of preventable morbidity and functional limitation in children. Long-term sequelae are measured best by the degree of impairment after recovery from the acute traumatic event. The specific aim of this study was to determine the quality of life and functional status of moderately to severely injured pediatric trauma patients at hospital discharge and at 1, 6, and 12 months postinjury.
Methods:
We conducted a prospective longitudinal study of children aged 1 to 18 years with blunt injury and Injury Severity Score >/= 9, excluding head and spinal cord injury. Children were evaluated at hospital discharge and at 1, 6, and 12 months postinjury, using the Child Health Questionnaire (CHQ), the Functional Independence Measure, and the Impact on Family Scale. Baseline and 1- and 6-month data analyses are reported.
Results:
One hundred sixty-two children were enrolled in the study, and 156 had completed 6-month data entry. The mean age was 9.3 +/- 5.3 years, and the mean Injury Severity Score was 14 +/- 7.4. The most common cause of injury was motor vehicular-related (43%). Fifty-eight (37%) had multisystem injuries. Femur fracture represented the most common injury (54.8%). Families experienced economic, social, and personal strain, as measured by the Impact on Family scale. There was a significant improvement in CHQ and Functional Independence Measure scores between baseline and 1 month and between 1 month and 6 months postinjury. However, at 6 months, physical scores remained lower than age-matched norms.
Conclusion:
Injury in children results in a significant burden on families. Although children demonstrate a rapid recovery of function and quality of life after blunt injury, physical function remains lower than age-matched norms at 6 months postinjury. It is unclear whether this represents a plateau in recovery or whether further improvements can be expected over longer time intervals.
Related Concept Videos
01:28Traumatic Brain Injury l: Introduction
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: