Injury severity variables as predictors of WeeFIM scores in pediatric TBI: Time to follow commands is best.
After pediatric traumatic brain injury (TBI), early prognosis of expected function is important for optimizing care. The power of several common brain injury severity measures for predicting functional outcome in children with TBI was investigated; the severity variables studied were Glasgow Coma Scale (GCS) score, time to follow commands (TFC), duration of post-traumatic amnesia (PTA), and total duration of impaired consciousness (TFC+PTA). Outcome was assessed using the Functional Independence Measure for Children (WeeFIM) at discharge from inpatient rehabilitation (n = 120) and, in a subset of children, at 3 months following discharge. Correlations and multiple linear regression analyses were conducted using GCS, TFC, PTA, and TFC+PTA to predict age-corrected WeeFIM scores. Models in which TFC and PTA duration were entered as separate variables and as a combined variable (TFC+PTA) were all significantly predictive of WeeFIM scores at discharge; however, TFC accounted for the greatest portion of variance in WeeFIM scores. Among children with moderate to severe TBI who received inpatient rehabilitation, TFC was the best predictor of general functional outcome at discharge and follow-up. Our findings highlight the need for careful and consistent assessment of TFC to assist in predicting functional outcomes as early and accurately as possible.
Suskauer
Stacy J
SJ
Kennedy Krieger Institute, Baltimore, MD, USA.
Slomine
Beth S
BS
Inscore
Anjeli B
AB
Lewelt
Aga J
AJ
Kirk
John W
JW
Salorio
Cynthia F
CF
Arch Phys Med Rehabil. 1994 Mar;75(3):328-37
8129588
J Neurotrauma. 2005 Oct;22(10):1040-51
16238482
J Pediatr. 1980 Nov;97(5):721-7
7431163
Dev Neurosci. 2006;28(4-5):244-55
16943648
Neurosurgery. 1988 Jun;22(6 Pt 1):1043-52
3419566
Dev Neurorehabil. 2008 Jan-Mar;11(1):39-50
17943500
Eur J Pediatr. 1993 Oct;152(10):844-7
8223789
Pediatr Neurol. 2006 May;34(5):379-87
16647999
J Clin Neuropsychol. 1984 Aug;6(3):267-86
6470165
J Head Trauma Rehabil. 2003 Nov-Dec;18(6):493-503
14707879
J Nerv Ment Dis. 1979 Nov;167(11):675-84
501342
Arch Neurol. 1961 Jul;5:4-17
13744864
J Int Neuropsychol Soc. 2001 Sep;7(6):683-92
11575590
Arch Neurol. 1994 Jul;51(7):661-70
8018038
Arch Phys Med Rehabil. 1996 Feb;77(2):125-32
8607735
J Neurosurg. 1981 Jun;54(6):751-62
7241184
Am J Med Genet. 1999 Jun 25;89(2):62-74
10559760
Arch Neurol. 1996 Aug;53(8):782-91
8759985
Clin Pediatr (Phila). 1994 Jul;33(7):421-30
7525140
J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):872-6
17178822
Curr Opin Crit Care. 2007 Apr;13(2):143-52
17327734
Childs Brain. 1979;5(3):174-91
456099
Neurosurgery. 1992 Aug;31(2):254-64
1513431
J Child Neurol. 1993 Oct;8(4):348-53
8228030
Lancet. 1974 Jul 13;2(7872):81-4
4136544
Brain Inj. 2005 Dec;19(13):1087-93
16286322
Lancet. 1975 Mar 1;1(7905):480-4
46957
Childs Brain. 1979;5(3):281-92
456104
Arch Phys Med Rehabil. 1997 Oct;78(10):1103-6
9339160
Arch Phys Med Rehabil. 2000 Mar;81(3):307-11
10724075
Phys Occup Ther Pediatr. 2001;21(2-3):91-101
12029858
J Pediatr Surg. 1987 Feb;22(2):127-9
3820007
Dev Neuropsychol. 2004;25(1-2):107-33
14984331
J Neurosurg. 1981 Mar;54(3):300-3
7463129
Acta Neurochir Suppl. 2005;93:207-8
15986757
Arch Phys Med Rehabil. 1997 Dec;78(12):1309-15
9421983
Pediatr Neurosurg. 2001 Feb;34(2):98-103
11287810
J Pediatr. 1992 Feb;120(2 Pt 1):195-9
1735814
Arch Phys Med Rehabil. 1982 Mar;63(3):118-23
7073452
J Pediatr Orthop. 2005 Nov-Dec;25(6):786-91
16294137
J Neurol Neurosurg Psychiatry. 1996 Apr;60(4):422-7
8774408
Arch Phys Med Rehabil. 2001 Oct;82(10):1355-9
11588737
Dev Med Child Neurol. 2005 Sep;47(9):609-12
16138668
Brain Inj. 2007 Aug;21(9):963-79
17729049
Dev Med Child Neurol. 1992 Oct;34(10):885-92
1397728
Arch Phys Med Rehabil. 2005 Apr;86(4):834-6
15827941
Neurosurgery. 1990 Nov;27(5):683-91; discussion 691
2259396
J Trauma. 1994 Jan;36(1):89-95
8295256
Pediatr Crit Care Med. 2006 Sep;7(5):461-7
16885795
Arch Phys Med Rehabil. 2003 Dec;84(12):1885-94
14669199
Lancet. 1976 May 15;1(7968):1031-4
57446
Clin Pediatr (Phila). 1994 Jul;33(7):431-8
7955782