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Change in functional status among children treated in the intensive care unit after injury

Omar Z Ahmed1, Richard Holubkov, J Michael Dean

  • 1From the Children's National Medical Center, Washington, DC 20010 (O.Z.A., R.S.B., M.M.P.); University of Utah School of Medicine, Salt Lake City, Utah 84108 (R.H., J.M.D.); Children's Hospital Colorado, Aurora, Colorado (T.D.B.); Children's Hospital of Michigan, Detroit, Michigan (K.L.M.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (R.A.B.); Children's Hospital Los Angeles, Los Angeles, California (C.J.L.N.); and Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (J.C.).

The Journal of Trauma and Acute Care Surgery
|November 17, 2018
PubMed

Insights

The Functional Status Scale (FSS) effectively measures morbidity in injured children, showing higher scores correlate with increased injury severity. This supports its use for assessing pediatric trauma outcomes.

Area of Science:

  • Pediatric Trauma Care
  • Clinical Outcome Measurement
  • Morbidity Assessment

Background:

  • Pediatric trauma mortality is declining, necessitating better morbidity assessment tools.
  • The Functional Status Scale (FSS) is a validated tool for assessing function in critically ill children.
  • Evaluating the FSS for overall pediatric injury morbidity is crucial.

Purpose of the Study:

  • To assess the Functional Status Scale (FSS) as an outcome measure for pediatric injury.
  • To determine the association between injury profiles and the development of morbidity in children.
  • To evaluate the FSS's utility in quantifying functional decline after trauma.

Main Methods:

  • Retrospective analysis of 553 injured children surviving to discharge.
  • Defined morbidity as changes in FSS domains (≥2) or overall FSS (≥3) from pre-injury to discharge.
  • Analyzed associations between injury characteristics (AIS severity, body regions) and FSS-defined morbidity.

Main Results:

  • New domain and overall morbidity were observed in 17.0% and 11.0% of patients, respectively.
  • Morbidity correlated with increased number of injured body regions, severe head/spine injuries, and moderate lower extremity injuries.
  • Severe spine and lower extremity injuries had the greatest impact, particularly on the motor domain.

Conclusions:

  • Increased Functional Status Scale (FSS) morbidity is linked to greater injury severity in children.
  • The FSS is a valuable metric for assessing outcomes in pediatric trauma patients.
  • Findings support FSS utilization for evaluating treatment impact and functional recovery.
Abstract

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