Research Reports - Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

Health Qual Life Outcomes. 2014 Feb 26;12(1):26

Andruszkow H(1), Deniz E, Urner J, Probst C, Grün O, Lohse R, Frink M, Krettek C, Zeckey C, Hildebrand F

BACKGROUND: Several studies have indicated that younger age is associated with
worse recovery after pediatric traumatic brain injury (TBI) compared to elder
children. In order to verify this association between long-term outcome after
moderate to severe TBI and patient's age, direct comparison between different
pediatric age groups as well as an adult population was performed.
METHODS: This investigation represents a retrospective cohort study at a level I
trauma center including patients with moderate to severe, isolated TBI with a
minimum follow-up of 10 years. According to their age at time of injury, patients
were divided in pre-school (0-7 years), school (8-17 years) and adult
(18-65 years) patients. Physical examination and standardized questionnaire on
physical and psychological aspects (Glasgow Outcome Scale, Barthel Index, Impact
of Event Scale, Hospital Anxiety and Depression Scale, short form 12) were
RESULTS: 135 traumatized patients were included. Physical and psychological
long-term outcome was associated with injury severity but not with patients' age
at time of injury. Outcome recovery measured by Glasgow Outcome Scale was
demonstrated with best results for pre-school aged children (p = 0.009).
According to the Hospital Anxiety and Depression Scale an increased incidence of
anxiety (p = 0.010) and depression (p = 0.026) was evaluated in older patients.
CONCLUSION: Long-term outcome perceptions after moderate to severe TBI presented
in this study question current views of deteriorated recovery for the immature
brain. The sustained TBI impact seemed not to reduce the child's ability to
overcome the suffered impairment measured by questionnaire based psychological,
physical and health related outcome scores. These results distinguish the
relevance of rehabilitation and family support in the long term.

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