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Pediatric minor injury outcomes: an initial report
Martha W Stevens1, Amy L Drendel, Keri R Hainsworth
1Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. mstevens@mcw.edu
Insights
Pediatric emergency department (PED) minor injury care leads to significant pain and disruption in daily activities for children and families. Study methods and the Pediatric Quality of Life Inventory (PedsQL) proved feasible for assessing these outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Quality of Life Assessment
Background:
- Minor injuries treated in pediatric emergency departments (PEDs) can result in substantial short-term morbidity.
- Previous research has not fully described outcomes following PED care for minor injuries.
- Assessing functional outcomes and quality of life in this setting is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate outcomes in children receiving care for minor injuries in a PED.
- To assess the feasibility of study methodologies in an acute care pediatric setting.
- To determine the usability of a health-related quality of life (HRQOL) tool for this population.
Main Methods:
- A prospective observational study design was employed.
- Clinical and functional short-term outcomes were tracked in pediatric patients with minor injuries.
- Telephone follow-up was conducted with families to gather data.
Main Results:
- A significant proportion of children experienced prolonged pain (24% >7 days) and delayed return to normal activities (37% >7 days).
- Family activities were disrupted in 50% of cases, with a median of 5 days of disruption.
- The Pediatric Quality of Life Inventory (PedsQL) demonstrated feasibility and initial construct validity in this population.
Conclusions:
- Pediatric emergency department treatment for minor injuries is associated with considerable short-term morbidity.
- The study's methods and the PedsQL tool are feasible for use in the PED setting.
- Further research is warranted to fully understand and mitigate the impact of minor injuries on children's quality of life.
Objectives:
The objectives were (1) to present a preliminary evaluation of outcomes after pediatric emergency department (PED) minor injury care (not previously described) and (2) to test the feasibility of study methods and of a HRQOL tool in this acute care setting.
Methods:
A prospective observational study of clinical and functional short-term outcomes in PED patients with minor injury was performed.
Results:
Thirty-five (80%) of 44 families completed telephone follow-up. Children had a median of 3 days of pain; 24% had pain for more than 7 days. Children returned to normal activity in a median of 3 days, and 37%, in more than 7 days. Fifty percent of families had normal activities disrupted, with median of 5 days and 39% in more than 7 days. Among children with school/scheduled activities, 55% missed more than 3 days, and 20% missed more than 7 days. Among parents who missed work/school, the mean was 1 day, and 22% missed more than 3 days. The acute Pediatric Quality of Life Inventory (PedsQL) was feasible for emergency department/follow-up use and had the expected inverse correlations with poor outcomes.
Conclusions:
We found significant morbidity after PED treatment of minor injury. The study methods and PedsQL patient and proxy forms were feasible for emergency department use. The PedsQL had some initial indications of construct validity for this population.
