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Children with traumatic head injury: morbidity and postacute treatment
C Di Scala1, J S Osberg, B M Gans
1Department of Rehabilitation Medicine, Tufts/New England Medical Center, Boston, MA 02111.
Insights
Pediatric head trauma can lead to lasting functional limitations, even in survivors. The severity and type of injury, along with age, influence outcomes and postacute care needs for children with head injuries.
Area of Science:
- Pediatric Traumatology
- Neurology
- Rehabilitation Medicine
Background:
- Head trauma is a significant cause of morbidity in children.
- Understanding factors influencing functional limitations is crucial for effective care.
- Previous research has not fully detailed the spectrum of outcomes and service needs.
Purpose of the Study:
- To describe pediatric head trauma.
- To identify factors affecting functional limitations after head injury.
- To outline postacute service requirements for affected children.
Main Methods:
- Analysis of data from the National Pediatric Trauma Registry (1985-1988).
- Inclusion of 4,870 children who survived head injuries.
- Exclusion of non-survivors and those with pre-existing impairments.
Main Results:
- Over 50% of survivors had associated extracranial injuries, influenced by age and injury mechanism.
- While 78% had no obvious impairments at discharge, many had one or more.
- 787 children had 1-3 impairments, and 286 had 4+ impairments.
Conclusions:
- Pediatric head trauma can result in diverse functional limitations.
- The extent of impairments dictates the need for rehabilitation or extended care.
- Age and injury mechanism are key factors in head trauma outcomes for children.
Abstract:
The purpose of this paper was to describe pediatric head trauma and the factors that affect the extent, characteristics, and postacute service needs of functional limitations resulting from head trauma. Data are presented on 4,870 children who survived head injuries and who were enrolled in the National Pediatric Trauma Registry during 1985 to 1988. The sample excluded 349 children who died and 151 children who had impairments before injury. More than 50% of the surviving children sustained extracranial injury in addition to head injury, and this occurrence was related to age and mechanism of injury. Although 78% of the children were discharged from acute care without obvious impairments, 787 had one to three impairments, and 286 had four or more impairments. Discharge to rehabilitation or extended care facilities depended on the number and type of resulting impairments.