期刊
PEDIATRICS
卷 117, 期 2, 页码 317-324出版社
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2005-0979
关键词
traumatic brain injury; child abuse; outcomes; shaken infant syndrome
类别
资金
- NICHD NIH HHS [K23 HD041040, K23 HD041040-01A2, K23 HD041040-03] Funding Source: Medline
- ODCDC CDC HHS [R49/CCR402444] Funding Source: Medline
OBJECTIVE. To assess outcomes 1 year after severe traumatic brain injury (TBI) among young children and to compare outcomes between children with inflicted versus noninflicted injuries. STUDY DESIGN. Prospective cohort study. METHODS. All North Carolina-resident children who were hospitalized between January 2000 and December 2001 in any of the state's 9 PICUs and who survived a severe TBI that occurred on or before their second birthday were eligible to participate. Child health status, child use of ancillary medical resources, and family characteristics were determined through maternal caregiver interviews similar to 1 year after injury. Comparisons were made between family characteristics and child outcomes according to injury type. RESULTS. Seventy-two interviews of maternal caregivers were completed among 112 survivors (64.3%). Children with inflicted injuries (n = 41) had worse outcomes than did children with noninflicted injuries (n = 31), as measured with the Pediatric Outcome Performance Category and Stein-Jessup Functional Status II ( Revised) tools. However, similar to 50% of children with inflicted injuries had only mild deficits or better. Children with inflicted injuries had a higher use of ancillary medical resources. Families caring for the children did not differ substantively, with a large proportion of single, working, minority mothers. CONCLUSIONS. Children with inflicted TBIs had worse outcomes than did children with other TBIs 1 year after injury. However, outcomes for these children were better than those reported previously. Many families caring for children after severe TBI are socially disadvantaged. Interventions to improve child outcomes may include enhanced family support.
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