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Long-Term Health-Related Quality of Life in Major Pediatric Trauma: A Pilot Study
Loes Janssens1,2, Jan Willem Gorter3, Marjolijn Ketelaar2,4
1Department of Rehabilitation and Sports Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Long-term health-related quality of life (HRQL) in children after major trauma is inconclusive. Teenagers with severe brain or spinal cord injuries reported the lowest HRQL, requiring special attention.
Area of Science:
- Pediatric trauma care
- Quality of life research
Background:
- Major trauma significantly impacts children's mortality and morbidity in developed nations.
- Health-related quality of life (HRQL) in pediatric trauma survivors remains under-researched.
- This study aims to assess long-term HRQL in children post-major trauma and compare it to healthy peers.
Purpose of the Study:
- To describe the long-term health-related quality of life (HRQL) in children who have experienced major trauma.
- To compare the HRQL of pediatric trauma survivors with that of healthy children.
Main Methods:
- A prospective cohort study involved severely injured children (Injury Severity Score ≥ 16, age < 16) admitted to a Dutch trauma center.
- Follow-up assessments were conducted 6–8 years post-trauma using the Pediatric Quality of Life Inventory (PedsQL 4.0), EuroQol 5D (EQ-5D), and EuroQol Visual Analogue Scale (EQ-VAS).
Main Results:
- The study followed 28 out of 40 severely injured children (mean age 8.9 years, mean ISS 24.9).
- While PedsQL scores were comparable to norms, EQ-5D indicated more health problems, and EQ-VAS scores were significantly lower than in healthy peers.
- Teenagers and those with spinal cord or severe cerebral injuries reported the lowest HRQL scores.
Conclusions:
- Long-term HRQL outcomes in pediatric major trauma survivors are not definitively established.
- Particular attention is warranted for teenagers with severe cerebral or spinal cord injuries due to their significantly lower reported HRQL.
- Further research is needed to understand and improve long-term HRQL in this vulnerable pediatric population.
Background:
Major trauma is the leading cause of mortality and morbidity in children of developed countries. Little research has been done about the health-related quality of life (HRQL) in these children. The aim of the current research is to describe the HRQL of children in the long term after major trauma and to compare it with healthy peers.
Methods:
A prospective cohort study of severely injured children (ISS ≥ 16, age < 16 years) who survived the trauma and were admitted to the emergency department of a Dutch level 1 trauma center in 1999 and 2000 (n = 40) was conducted. Between 6 and 8 years after trauma (mean 7.3, SD 0.7 years), outcome was assessed by the Pediatric Quality of Life Inventory (PedsQL 4.0), the EuroQol 5D (EQ-5D), and the EuroQol Visual Analogue Scale (EQ-VAS).
Results:
The mean age at the time of the accident was 8.9 years (SD 4.6 years), the mean ISS was 24.9 (SD 11.1), and 25 (63%) cases were male; 28 out of 40 patients were followed up. The mean score on the PedsQL was 81.2 and this did not differ significantly from the norm value. On the EQ-5D, more health problems were reported than in a healthy reference population. The mean EQ-VAS score was 79.4 and was significantly lower than in healthy peers. The lowest scores on the PedsQL and the EQ-VAS were seen in teenagers and in respondents with spinal cord and/or severe cerebral injury.
Conclusion:
The results on HRQL in children in the long term after major trauma are inconclusive. Special attention should be given to teenagers with spinal cord or severe cerebral injury who reported the lowest HRQL.
