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Improving access to pediatric neurorehabilitation for patients with moderate and severe head injuries
Rajib Lodh1, Poppy Siddell2, Jonathan Jones3
1a Regional Paediatric Neurorehabilitation Services , The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary , Leeds , UK.
Insights
Access to pediatric neurorehabilitation is a concern, with only 39% of children with head injuries receiving it. Improved neurorehabilitation access is crucial for better outcomes in major trauma patients.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Rehabilitation Medicine
Background:
- Most severely injured children in England sustain head injuries and are treated in Major Trauma Centers (MTCs).
- The period post-brain injury is critical for influencing neurological recovery.
- This study investigated neurorehabilitation referral rates for pediatric head injury patients.
Purpose of the Study:
- To determine the rate of neurorehabilitation referrals for children with head injuries.
- To identify factors associated with neurorehabilitation referral in this population.
Main Methods:
- A retrospective study was conducted over one year at a single center.
- Children with moderate to severe head injuries were identified.
- Referral status for neurorehabilitation was compared against patient demographics and injury characteristics.
Main Results:
- Out of 41 identified pediatric patients, only 16 (39%) were referred for neurorehabilitation.
- Referral status was significantly associated with patient age, injury mechanism, injury severity, and imaging findings.
Conclusions:
- The findings highlight significant concerns regarding access to pediatric neurorehabilitation services.
- Enhanced access to neurorehabilitation, including long-term follow-up, is necessary.
- Major Trauma Centers present an opportunity to improve neurorehabilitation referral pathways.
Introduction:
The majority of severely injured children in England have a significant head injury and will be seen in Major Trauma Centers (MTCs). The period following brain injury represents an opportunity to influence recovery of neurological function. The study sought to determine whether children who had sustained a head injury were referred for neurorehabilitation.
Method:
The study was conducted over one year at one center. Children sustaining a moderate or severe head injury were identified and compared to those referred for neurorehabilitation.
Results:
A total of 41 patients were identified; 16/41 (39%) were referred for neurorehabilitation. Group comparison revealed significant associations between referral status and age (X2(3) = 8.35, p = 0.039), injury mechanism (X2(1) = 8.12, p = 0.017), injury severity (X2(1) = 21.3, p < 0.000), and imaging findings (X2(1) = 11.71, p = 0.001).
Discussion:
Data reveal concerns for access to neurorehabilitation. Improved access to neurorehabilitation permitting long-term follow-up is required. The establishment of MTCs provides an opportunity to enact this.
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