title: Prevalence of and risk factors for poor functioning after isolated mild traumatic brain injury in children.
abstract: This study aimed to determine the prevalence and predictors of poor 3 and 12 month quality of life outcomes in a cohort of pediatric patients with isolated mild TBI. We conducted a prospective cohort study of children and adolescents <18 years of age treated for an isolated mild TBI, defined as "no radiographically apparent intracranial injury" or "an isolated skull fracture, and no other clinically significant non-brain injuries." The main outcome measure was the change in quality of life from baseline at 3 and 12 months following injury, as measured by the Pediatric Quality of Life index (PedsQL). Poor functioning was defined as a decrease in total PedsQL score of >15 points between baseline and follow-up scores (at 3 and 12 months). Of the 329 patients who met inclusion criteria, 11.3% (95% CI 8.3-15.3%) at 3 months and 12.9% (95% CI 9.6-17.2%) at 12 months following injury had relatively poor functioning. Significant predictors of poor functioning included less parental education, Hispanic ethnicity (at 3 months following injury, but not at 12 months); low household income (at 3 and 12 months), and Medicaid insurance (at 12 months only). Children and adolescents sustaining a mild TBI who are socioeconomically disadvantaged may require additional intervention to mitigate the effects of mild TBI on their functioning.
authors.affiliation: 1 Center for Injury Research and Prevention, and the Division of Emergency Medicine, The Children's Hospital of Philadelphia; Department of Pediatrics and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Zonfrillo
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Durbin
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Koepsell
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Temkin
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Dorsch
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Jaffe
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors