Long-term health condition in major pediatric trauma: a pilot study.
OBJECTIVE
Major trauma is the leading cause of death in children of developed countries. However, little is known about its long-term health consequences in survivors. Our aim was to describe the health condition in children at long-term after major trauma.


METHODS
Prospective cohort study of severely injured children (Injury Severity Score > or =16, age <16) admitted to a Dutch level I trauma center in 1999 to 2000 (N = 40). About 7 years after trauma (median, 7.3; range, 6.3-8.2 years), survivors' health condition was assessed with the following: guides to the evaluation of permanent impairment of the American Medical Association (AMA-guides), Glasgow Outcome Scales (GOS/GOSE), Vineland Adaptive Behavior Scales (VABS), Child Behavior Checklist (CBCL), and Strengths and Difficulties Questionnaire (SDQ).


RESULTS
Of 40 children, 28 were followed up. Most (n = 16; 57%) had no impairments (AMA guides); minor to severe impairments were found in 12 of the respondents. About 80% (n = 22) had good recovery (GOS 5 and GOSE 7/8); the remaining had moderately disability (GOS 4 or GOSE 5/6). The mean scores on the VABS and the frequency of behavioral problems on the CBCL (24%) and the SDQ (20%) were comparable to healthy peers.


CONCLUSIONS
This long-term follow-up study after major trauma revealed that most children had a health condition comparable to healthy peers; about 40% of the respondents was physically impaired or restricted in daily activities. Our experiences with different measures may be helpful to apply age-appropriate outcome measures for the clinical follow-up of children after major trauma and to design future longitudinal studies.
Janssens
Loes
L
Department of Rehabilitation and Sports Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Gorter
Jan Willem
JW
Ketelaar
Marjolijn
M
Kramer
William L M
WL
Holtslag
Herman R
HR
D000293:Adolescent; D002648:Child; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D014947:Wounds and Injuries / Q000453:epidemiology / Q000503:physiopathology* / Q000534:rehabilitation