Functional status after childhood traumatic brain injury.
BACKGROUND
Identification of children after traumatic brain injury (TBI) likely to have functional deficits at trauma center discharge will facilitate care.


METHODS
Two logistic regression models were derived from data on 4,439 children after TBI 7 to 14 years old enrolled in the National Pediatric Trauma Registry between 1994 and 2001 to predict physical and cognitive disabilities.


RESULTS
Children with open or multiple fractures or closed fractures or injured by motor vehicles were 8.2, 3.5, or 2.5 times more likely, respectively, than those without those circumstances to have discharge physical disabilities. Likelihood of cognitive impairment was increased by factors of 3.2 and 5.8 in children obtunded or comatose on arrival. Preexisting cognitive deficits, injury severity, and intubation predicted physical and cognitive disabilities. The C statistic was 0.862 for the motor model and 0.860 for the cognitive model.


CONCLUSIONS
Predicting the likelihood of morbidity after acute management of childhood TBI can provide information pertinent to providing effective care.
Wechsler
Barbara
B
Rehabilitation Program, Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland, Ohio 44104, USA. wechsleb@ccf.org
Kim
Heakyung
H
Gallagher
Paul R
PR
DiScala
Carla
C
Stineman
Margaret G
MG
D000293:Adolescent; D017677:Age Distribution; D001930:Brain Injuries / Q000453:epidemiology*; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D015233:Models, Statistical; D016472:Motor Neuron Disease / Q000453:epidemiology*; D016017:Odds Ratio; D012372:ROC Curve; D020127:Recovery of Function; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology