title: Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina: A Multicenter Randomized Controlled Trial.
abstract: To develop, in partnership with families of children with traumatic brain injury, a postdischarge intervention that is effective, simple, and sustainable.
  
  
  
  Randomized Controlled Trial.
  
  
  
  Seven Level 1 Pediatric Trauma Centers in Argentina.
  
  
  
  Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild traumatic brain injury and were discharged alive.
  
  
  
  Patients were randomly assigned to either the intervention or standard care group. A specially trained Community Resource Coordinator was assigned to each family in the intervention group. We hypothesized that children with severe, moderate, and complicated mild traumatic brain injury who received the intervention would have significantly better functional outcomes at 6 months post discharge than those who received standard care. We further hypothesized that there would be a direct correlation between patient outcome and measures of family function.
  
  
  
  The primary outcome measure was a composite measured at 6 months post injury. There were 308 patients included in the study (61% men). Forty-four percent sustained a complicated mild traumatic brain injury, 18% moderate, and 38% severe. Sixty-five percent of the patients were 8 years old or younger, and over 70% were transported to the hospital without ambulance assistance. There was no significant difference between groups on the primary outcome measure. There was a statistically significant correlation between the primary outcome measure and the scores on the Family Impact Module of the Pediatric Quality of Life Inventory (ρ = 0.57; p < 0.0001). Children with better outcomes lived with families reporting better function at 6 months post injury.
  
  
  
  Although no significant effect of the intervention was demonstrated, this study represents the first conducted in Latin America that documents the complete course of treatment for pediatric patients with traumatic brain injury spanning hospital transport through hospital care and into the postdischarge setting.
authors.affiliation: 1Oregon Health and Science University, Portland, OR. 2Centro de Informática e Investigación Clínica, Rosario, Argentina. 3Universidad Nacional de Rosario, Rosario, Argentina. 4Hospital de Niños Víctor J Vilela, Rosario, Argentina. 5Department of Psychology, Portland State University, Portland, OR. 6Sistema Integrado de Emergencia Sanitaria, Rosario, Argentina. 7Hospital El Cruce, Florencio Varela, Argentina. 8University of Washington, Seattle, WA. 9Hospital Interzonal Especializado Materno Infantil Dr. Vitorio Tetamanti, Mar del Plata, Argentina. 10Hospital de Niños Sor María Ludovica, La Plata, Argentina. 11Hospital de Niños "Dr. Orlando Alassia", Santa Fe, Argentina. 12Hospital de Niños de la Santísima Trinidad, Córdoba, Argentina. 13Hospital Pediátrico Dr. Humberto Notti, Mendoza, Argentina.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Carney
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Petroni
authors.forename: Silvia B
authors.initials: SB
authors.lastname: Luján
authors.forename: Nicolás M
authors.initials: NM
authors.lastname: Ballarini
authors.forename: Gabriela A
authors.initials: GA
authors.lastname: Faguaga
authors.forename: Hugo E M
authors.initials: HE
authors.lastname: du Coudray
authors.forename: Amy E
authors.initials: AE
authors.lastname: Huddleston
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Baggio
authors.forename: Juan M
authors.initials: JM
authors.lastname: Becerra
authors.forename: Leonardo O
authors.initials: LO
authors.lastname: Busso
authors.forename: Sureyya S
authors.initials: SS
authors.lastname: Dikmen
authors.forename: Roberto
authors.initials: R
authors.lastname: Falcone
authors.forename: Mirta E
authors.initials: ME
authors.lastname: García
authors.forename: Osvaldo R
authors.initials: OR
authors.lastname: González Carrillo
authors.forename: Paula L
authors.initials: PL
authors.lastname: Medici
authors.forename: Marta B
authors.initials: MB
authors.lastname: Quaglino
authors.forename: Carina A
authors.initials: CA
authors.lastname: Randisi
authors.forename: Silvia S
authors.initials: SS
authors.lastname: Sáenz
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Temkin
authors.forename: Elida E
authors.initials: EE
authors.lastname: Vanella
mesh_terms: D000293:Adolescent; D001118:Argentina; D000070642:Brain Injuries, Traumatic / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011788:Quality of Life; D016037:Single-Blind Method; D014193:Trauma Centers / Q000458:organization & administration; D016896:Treatment Outcome; D055815:Young Adult