The Westmead Pediatric TBI Multidisciplinary Outcome study: use of functional outcomes data to determine resource prioritization.
OBJECTIVE
To measure functional outcome in the 2 years after traumatic brain injury (TBI) in 2 groups of children and to determine the usefulness of a TBI severity classification system for resource allocation.


METHODS
Prospective inception cohort study with 3 assessment points during the 2 years after trauma.


METHODS
Tertiary pediatric trauma center in Sydney, Australia.


METHODS
Eighty-one consecutive admissions aged 0 to 14 years. Fifty-one were allocated to the Mild (n = 26) or Severe (n = 25) TBI groups, according to preset determinants of severity; 30 admissions with non-TBI trauma constituted the control group.


METHODS
Standardized psychometric and clinical assessments of cognition, communication and feeding ability, motor performance (ambulation, fine and gross motor), neurologic status, self-care independence, and school/academic performance.


RESULTS
Those with Mild TBI severity had no significant deficits at the 2-year data point. In contrast, those in the Severe TBI group demonstrated continued problems with fine motor performance, neurologic status, self care, and school/academic performance.


CONCLUSIONS
A classification system has been developed that may be useful in the allocation of children with a TBI, age younger than 15 years, to 1 of 2 severity groups early in their rehabilitation. This classification system may be useful in determining areas of high and low resource prioritization.
O'Flaherty
S J
SJ
Department of Paediatrics, Westmead Hospital, Sydney, Australia.
Chivers
A
A
Hannan
T J
TJ
Kendrick
L M
LM
McCartney
L C
LC
Wallen
M A
MA
Doggett
C
C
D000293:Adolescent; D001315:Australia; D001930:Brain Injuries / Q000145:classification* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D003142:Communication; D005260:Female; D015276:Health Care Rationing; D006292:Health Priorities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics; D011597:Psychomotor Performance; D014193:Trauma Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome