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A longitudinal study on quality of life after injury in children
Amy Schneeberg1,2,3, Takuro Ishikawa2,3, Sami Kruse3
1School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada.
Insights
Childhood injuries significantly impact health-related quality of life (HRQoL), especially in hospitalized children. Most children recover within four months, but some hospitalized youth experience lasting physical HRQoL deficits.
Area of Science:
- Pediatric Health
- Injury Epidemiology
- Quality of Life Research
Background:
- Childhood injuries are a leading cause of death and morbidity in high-income countries.
- There is a need for studies examining the long-term effects of injuries on children's health-related quality of life (HRQoL).
- This study focuses on HRQoL across multiple health domains at specific post-injury time points.
Purpose of the Study:
- To describe the impact of childhood injury on health-related quality of life (HRQoL).
- To track recovery patterns in HRQoL for 12 months post-injury.
- To identify factors associated with changes in HRQoL after injury.
Main Methods:
- Prospective cohort study of children (0-16 years) treated for injuries at British Columbia Children's Hospital.
- HRQoL surveys administered at baseline (pre-injury), and at 1, 4-6, and 12 months post-injury.
- Generalized estimating equation models used to analyze factors influencing HRQoL changes over time.
Main Results:
- 256 children completed baseline surveys; follow-up response rates ranged from 64-74%.
- Mean HRQoL scores improved from 77.8 at 1 month to 91.3 at 12 months post-injury.
- Older age and hospitalization were associated with a slower recovery slope but similar long-term outcomes by 4 months.
Conclusions:
- Most childhood injuries have limited long-term HRQoL impact, with recovery typically occurring by 4 months post-injury.
- Hospitalized children showed persistent deficits in physical HRQoL at 4 and 12 months post-injury.
- While hospitalization affected short-term HRQoL, long-term psychosocial recovery was not significantly impacted.
Background:
In high income countries, injuries account for 40 % of all child deaths, representing the leading cause of child mortality and a major source of morbidity. The need for studies across age groups, and use of health related quality of life measures that assess functional limitations in multiple health domains, with sampling at specific post-injury time points has been identified. The objective of this study was to describe the impact of childhood injury and recovery on health related quality of life (HRQoL) for the 12 months after injury.
Methods:
In this prospective cohort study parents of children 0-16 years old attending British Columbia Children's Hospital for an injury were surveyed over 12 months post-injury. Surveys assessed HRQoL at four points: baseline (pre-injury), one month, four to six months and 12 months post injury. Generalized estimating equation models identified factors associated with changes in HRQoL over time.
Results:
A total of 256 baseline surveys were completed. Response rates for follow-ups at one, four and twelve months were 74 % (186), 67 % (169) and 64 % (161), respectively. The mean age of participants was 7.9 years and 30 % were admitted to the hospital. At baseline, a retrospective measure of pre-injury health, the mean HRQoL score was 90.7. Mean HRQoL ratings at one, four and 12 months post injury were 77.8, 90.3 and 91.3, respectively. Both being older and being hospitalized were associated with a steeper slope to recovery.
Conclusions:
Although injuries are prevalent, the long term impacts of most childhood injuries are limited. Regardless of injury severity, most injured children recuperated quickly, and had regained total baseline status by four month post-injury. However, although hospitalization did not appear to impact long term psychosocial recovery, at four and 12 months post injury a greater proportion of hospitalized children continued to have depressed physical HRQoL scores. Both older and hospitalized children reported greater impact to HRQoL at one month post injury, and both had a steeper slope to recovery and were on par with their peers by four month.
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