Disability 3, 12, and 24 months after traumatic brain injury among children and adolescents.
OBJECTIVE
To examine disability in children and adolescents after traumatic brain injury (TBI) across the spectrum of injury severity.


METHODS
This was a prospective cohort study of children younger than 18 years treated for a TBI (n = 729) or an arm injury (n = 197) between March 1, 2007, and September 30, 2008. The main outcome measures were disability in health-related quality of life, adaptive skills, and participation in social and community activities 3, 12, and 24 months after injury compared with preinjury functioning.


RESULTS
The health-related quality of life for children with moderate or severe TBI was lower at all follow-up times compared with baseline, but there was some improvement during the first 2 years after injury. Three months after injury, there was a substantial decrease in the level of activities in which children with moderate and severe TBI were able to participate; these activities improved at 12 and 24 months but were still significantly impaired. Communication and self-care abilities in children with moderate and severe TBI were lower at 3 months than at baseline and did not improve by 24 months. Children who met the definition of mild TBI but had an intracranial hemorrhage had lower quality-of-life scores at 3 months.


CONCLUSIONS
Children with moderate or severe TBI and children with mild TBI who had intracranial hemorrhage had substantial long-term reduction in their quality of life, participation in activities with others, and ability to communicate and care for themselves.
Department of Pediatrics, University of Washington, Seattle, Washington, USA. fpr@uw.edu
Frederick P
FP
Rivara
Thomas D
TD
Koepsell
Jin
J
Wang
Nancy
N
Temkin
Andrea
A
Dorsch
Monica S
MS
Vavilala
Dennis
D
Durbin
Kenneth M
KM
Jaffe
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000209:etiology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D013997:Time Factors; D014481:United States