Research Reports - Prevalence of and risk factors for poor functioning after isolated mild traumatic brain injury in children

J Neurotrauma. 2014 Jan 9

Zonfrillo MR, Durbin DR, Koepsell TD, Wang J, Temkin NR, Dorsch AM, Vavilala MS, Jaffe KM, Rivara FP

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.

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