title: Improving access to pediatric neurorehabilitation for patients with moderate and severe head injuries.
abstract: BACKGROUND
  The majority of severely injured children in England have a significant head injury and will be seen in Major Trauma Centers (MTCs). The period following brain injury represents an opportunity to influence recovery of neurological function. The study sought to determine whether children who had sustained a head injury were referred for neurorehabilitation.
  
  
  METHODS
  The study was conducted over one year at one center. Children sustaining a moderate or severe head injury were identified and compared to those referred for neurorehabilitation.
  
  
  RESULTS
  A total of 41 patients were identified; 16/41 (39%) were referred for neurorehabilitation. Group comparison revealed significant associations between referral status and age (X2(3) = 8.35, p = 0.039), injury mechanism (X2(1) = 8.12, p = 0.017), injury severity (X2(1) = 21.3, p < 0.000), and imaging findings (X2(1) = 11.71, p = 0.001).
  
  
  CONCLUSIONS
  Data reveal concerns for access to neurorehabilitation. Improved access to neurorehabilitation permitting long-term follow-up is required. The establishment of MTCs provides an opportunity to enact this.
authors: a Regional Paediatric Neurorehabilitation Services , The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary , Leeds , UK.
authors: Rajib
authors: R
authors: Lodh
authors: b Paediatric Neuropsychology , The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary , Great George Street, Leeds , UK.
authors: Poppy
authors: P
authors: Siddell
authors: c Emergency Medicine , The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary , Great George Street, Leeds , UK.
authors: Jonathan
authors: J
authors: Jones
authors: b Paediatric Neuropsychology , The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary , Great George Street, Leeds , UK.
authors: Matthew C H J
authors: MCHJ
authors: Morrall
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000534:rehabilitation*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D000066530:Neurological Rehabilitation / Q000592:standards*; D014193:Trauma Centers / Q000592:standards*; D006113:United Kingdom
keywords: Evaluation; head injury; outcome; pediatric; quality improvement