Pediatric polytrauma: short-term and long-term outcomes.
OBJECTIVE
To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes.


METHODS
All pediatric polytrauma patients (Injury Severity Score of > or = 16, < or = 15 years of age) who were treated at a Level I trauma center between 1985 and 1989 and who were 18 years or older at follow-up (1996) were included. Short-term outcomes were quantified using the Glasgow Outcome Scale. The Functional Independence Measure, the RAND-36, and questions on social outcome were used to assess long-term outcomes.


RESULTS
Fifty-nine of 74 patients survived (80%). At 1 year after injury, 22% were disabled, mainly due to severe brain injuries, and 32% had changed school. After 9 years of follow-up, the degree of physical disablement was low (12%). Cognitive impairments were found in 42% of the patients. Only 10% were in receipt of disablement allowances; 76% were employed or attended school. The quality of life enjoyed by the patients (RAND-36) did not differ from that enjoyed by a healthy reference population. The Glasgow Outcome Scale (from 6 weeks onward) was a good predictor of long-term disablement.


CONCLUSIONS
Although the short-term impact of injuries is extensive, the long-term outcomes are satisfactory. Severe injuries sustained during childhood do not lead to a diminished quality of life during adulthood.
van der Sluis
C K
CK
Department of Rehabilitation, University Hospital Groningen, The Netherlands.
Kingma
J
J
Eisma
W H
WH
ten Duis
H J
HJ
D000293:Adolescent; D002648:Child; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D016014:Linear Models; D008297:Male; D009104:Multiple Trauma / Q000150:complications / Q000401:mortality / Q000523:psychology; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012042:Registries; D011795:Surveys and Questionnaires; D013997:Time Factors