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Caregiver reported long-term outcomes in children with major trauma and traumatic brain injuries: A single-centre
Joel Song Kai Koh1, Zhi Min Ng2, Jasmine Xun Yi Feng1
1Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.
Insights
Pediatric trauma patients with traumatic brain injury (TBI) showed improved quality of life and function 6-12 months post-injury. These findings highlight positive long-term outcomes with standard care for pediatric TBI.
Area of Science:
- Pediatric Traumatology
- Neurotrauma
- Quality of Life Research
Background:
- Major trauma in children, particularly with traumatic brain injury (TBI), significantly impacts functional outcomes and long-term health-related quality of life (HRQOL).
- Understanding the trajectory of recovery and HRQOL in this vulnerable population is crucial for optimizing care.
- Previous studies have focused on acute outcomes, with less emphasis on long-term functional gains and quality of life post-pediatric TBI.
Purpose of the Study:
- To investigate the functional outcomes and long-term health-related quality of life (HRQOL) in children who sustained major trauma with traumatic brain injury (TBI).
- To assess changes in physical and psychosocial functioning and overall quality of life from 6 to 12 months post-injury.
- To evaluate the effectiveness of current standard care in promoting recovery and improving HRQOL in pediatric trauma patients with TBI.
Main Methods:
- Retrospective review of medical records for patients aged 2-16 years with major trauma (Injury Severity Score ≥16) and TBI.
- Data collection included Glasgow Outcome Scale-Extended Pediatric Version (GOS-E Peds) at 12 months and Pediatric Quality of Life Inventory (PedsQL) scores at 6 and 12 months post-injury.
- Parent proxy-report scales were used for PedsQL assessments, with statistical analysis of functional scores and quality of life metrics.
Main Results:
- Fifty-three pediatric patients with a median age of 9.0 years were included; common causes were falls and road traffic collisions.
- A significant majority (77.3%) required intensive care, and 56.6% underwent neurosurgical intervention.
- Statistically significant improvements were observed in parent-reported physical functioning (P=0.041), psychosocial functioning (P=0.012), and overall scores (P=0.008) between 6 and 12 months post-injury, with PedsQL scores higher across all domains at 12 months.
Conclusions:
- Parents of children with major trauma and TBI reported notable gains in quality of life, physical, and psychosocial functioning between 6 and 12 months post-injury.
- The findings suggest that current standard care protocols contribute positively to the long-term recovery and well-being of pediatric patients with TBI.
- Further research could explore specific interventions that may further enhance functional recovery and HRQOL in this population.
Introduction:
We aim to investigate the functional outcomes and long-term health-related quality of life (HRQOL) in children with major trauma associated with traumatic brain injury (TBI).
Method:
We performed a retrospective review of records among patients >2 and ≤16 years old in a tertiary paediatric hospital between January 2014 and October 2019 with major trauma (Injury Severity Score of ≥16) and TBI of all severities. We recorded each child's Glasgow Outcome Scale-Extended Pediatric Version (GOS-E Peds) at 12 months post-injury and Pediatric Quality of Life Inventory (PedsQL) scores at 6 and 12 months post-injury based on the parent proxy-report scales.
Results:
We included 53 patients with a median age of 9.0 years old (interquartile range 2.3-15.5). Most injuries were due to falls (30, 56.6%) or road traffic collisions (15, 28.3%); 41 patients (77.3%) required intensive care while 30 patients (56.6%) underwent neurosurgical intervention. Most patients (43, 81.1%) had GOS-E Peds scores of ≤2 at 12 months post-injury. We reported a significant mean difference between the 6- and 12-month parent-reported scores for physical functioning (6.6, 95% confidence interval [CI] 0.3-12.8, P=0.041), psychosocial functioning (4.1, 95% CI 1.0-7.2, P=0.012) and overall scores (5.0, 95% CI 1.4-8.7, P=0.008). Compared with the validated PedsQL scores, our mean scores were higher across all domains at 12 months.
Conclusion:
With current standard of care, parents of children with major trauma and TBI reported gains in quality of life, physical, psychosocial and overall function between 6 and 12 months post-injury.
