Health-related quality of life during the first year after traumatic brain injury.
OBJECTIVE
To document health-related quality of life (HRQOL) of children with traumatic brain injury (TBI) and to examine the relationship between TBI severity and HRQOL during the first year after injury.


METHODS
Prospective cohort study.


METHODS
Four pediatric level I trauma centers.


METHODS
Children with TBI (n = 330).


METHODS
Traumatic brain injury.


METHODS
A primary caregiver completed telephone interviews at baseline, 3 months, and 12 months to measure the child's HRQOL using the Pediatric Quality of Life Inventory. The HRQOL outcomes were modeled as a function of injury, patient characteristics, and family characteristics using longitudinal, multivariable regression.


RESULTS
A considerable proportion of children had impaired HRQOL at 3 months (42% of children) and 12 months (40% of children) after injury. Multiple dimensions of HRQOL were negatively affected among children with moderate or severe TBI (decrease of 3.7 to 17.6) (P<.05) and did not improve significantly over time. Concomitant lower extremity fractures and spinal injuries resulted in large declines in overall HRQOL, particularly at 3 months after injury (decrease of 12.9 and 8.1, respectively) (P<.05). The HRQOL scores were also reduced by preexisting psychosocial conditions (decrease of 2.9 to 12.3), impaired family functioning (decrease of 5.1 to 6.8), having Medicaid coverage or being uninsured (decrease of 3.1 to 5.5), and single-parent households (decrease of 3.2 to 3.4) (P<.05).


CONCLUSIONS
Moderate or severe TBI resulted in measurable declines in children's HRQOL after injury. Injury-related factors impacted HRQOL more compared with patient and family characteristics during the first year after injury.
McCarthy
Melissa L
ML
Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. mmccarth@jhmi.edu
MacKenzie
Ellen J
EJ
Durbin
Dennis R
DR
Aitken
Mary E
ME
Jaffe
Kenneth M
KM
Paidas
Charles N
CN
Slomine
Beth S
BS
Dorsch
Andrea M
AM
Christensen
James R
JR
Ding
Ru
R
D000293:Adolescent; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D015588:Observer Variation; D010290:Parents; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires