Longitudinal follow-up of families and young children with traumatic brain injury

被引:45
作者
Keenan, HT
Runyan, DK
Nocera, M
机构
[1] Univ Utah, Intermt Control Res Ctr, Salt Lake City, UT 84158 USA
[2] Univ Utah, Dept Pediat, Salt Lake City, UT 84158 USA
[3] Univ N Carolina, Dept Social Med, Chapel Hill, NC USA
[4] Univ N Carolina, Dept Pediat, Chapel Hill, NC USA
[5] Univ N Carolina, Univ N Carolina Canc Injury Prevent Res Ctr, Chapel Hill, NC USA
关键词
traumatic brain injury; outcomes; child abuse; shaken baby syndrome;
D O I
10.1542/peds.2005-1883
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVES. To examine the stability of functional outcomes 2 years after injury among children who sustained a traumatic brain injury (TBI) before 2 years of age and to examine the characteristics of the families caring for these children. METHODS. All North Carolina-resident children who were hospitalized between January 2000 and December 2001 in any of the state's 9 PICUs and survived a TBI that occurred on or before their second birthday were eligible to participate in the prospective cohort study. Child health status, use of ancillary medical resources, and family characteristics were assessed through maternal caregiver interviews similar to 2 years after injury. Comparisons were made among injury types ( inflicted versus noninflicted). RESULTS. There were 112 children who survived a TBI during the 2-year study period. Fifty-seven (79%) of the 72 maternal caregivers who had completed an interview 1 year after the child's injury participated in the year 2 interview. Most children (67%) had an outcome of mild disability or better at year 2, with 45% functioning at an age-appropriate level. Children's outcomes did not differ significantly at year 2 according to the mechanism of injury. The majority ( 67%) of children retained their Pediatric Overall Performance Category scores from year 1 to year 2. Children who changed were as likely to show improvement as deterioration. Children differed very little across time, as measured with the Stein-Jessup Functional Status II ( Revised) scale. Families tended to have multiple environmental factors that could put their children at risk for poor developmental outcomes, including living below the poverty level (22%) and low social capital (39%). CONCLUSIONS. The children in this cohort had relatively stable functional outcomes from year 1 to year 2 after injury. This population of children remains very vulnerable to poor developmental outcomes secondary to the effects of their TBI and environmental factors.
引用
收藏
页码:1291 / 1297
页数:7
相关论文
共 17 条
[1]  
[Anonymous], 1975, 4 FACTOR INDEX SOCIA
[2]   SOCIAL CAPITAL IN THE CREATION OF HUMAN-CAPITAL [J].
COLEMAN, JS .
AMERICAN JOURNAL OF SOCIOLOGY, 1988, 94 :S95-S120
[3]   Executive functions following traumatic brain injury in young children: A preliminary analysis [J].
Ewing-Cobbs, L ;
Prasad, MR ;
Landry, SH ;
Kramer, L ;
DeLeon, R .
DEVELOPMENTAL NEUROPSYCHOLOGY, 2004, 26 (01) :487-512
[4]   Modeling of longitudinal academic achievement scores after pediatric traumatic brain injury [J].
Ewing-Cobbs, L ;
Barnes, M ;
Fletcher, JM ;
Levin, HS ;
Swank, PR ;
Song, J .
DEVELOPMENTAL NEUROPSYCHOLOGY, 2004, 25 (1-2) :107-133
[5]  
Ewing-Cobbs L, 1997, J Int Neuropsychol Soc, V3, P581
[6]   Relationship of Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores at pediatric intensive care unit discharge with outcome measures collected at hospital discharge and 1-and 6-month follow-up assessments [J].
Fiser, DH ;
Long, N ;
Roberson, PK ;
Hefley, G ;
Zolten, K ;
Brodie-Fowler, M .
CRITICAL CARE MEDICINE, 2000, 28 (07) :2616-2620
[7]   ASSESSING THE OUTCOME OF PEDIATRIC INTENSIVE-CARE [J].
FISER, DH .
JOURNAL OF PEDIATRICS, 1992, 121 (01) :68-74
[8]   A population-based study of inflicted traumatic brain injury in young children [J].
Keenan, HT ;
Runyan, DK ;
Marshall, SW ;
Nocera, MA ;
Merten, DF ;
Sinal, SH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (05) :621-626
[9]   Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial [J].
Olds, DL ;
Kitzman, H ;
Cole, R ;
Robinson, J ;
Sidora, K ;
Luckey, DW ;
Henderson, CR ;
Hanks, C ;
Bondy, J ;
Holmberg, J .
PEDIATRICS, 2004, 114 (06) :1550-1559
[10]  
POLITZ K, 2001, CONSUMERS GUIDE GETT