TY - JOUR
T1 - Long-Term Outcomes after Pediatric Injury
T2 - Results of the Assessment of Functional Outcomes and Health-Related Quality of Life after Pediatric Trauma Study
AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network Assessment of Functional Outcomes and Health-Related Quality of Life after Pediatric Trauma Investigators
AU - Burd, Randall S.
AU - Jensen, Aaron R.
AU - VanBuren, John M.
AU - Alvey, Jessica S.
AU - Richards, Rachel
AU - Holubkov, Richard
AU - Pollack, Murray M.
AU - Carcillo, Joseph A.
AU - Carpenter, Todd C.
AU - Mourani, Peter M.
AU - Dean, J. Michael
AU - Hall, Mark W.
AU - Yates, Andrew R.
AU - McQuillen, Patrick S.
AU - Meert, Kathleen L.
AU - Nance, Michael L.
N1 - Funding Information:
Support: This work was supported by NIH grant numbers UG1HD049981 , U01HD049934 , UG1HD049983 , UG1HD083170 , UG1HD083166 , UG1HD050096 , and UG1HD083171 .
Funding Information:
Disclosures outside the scope of this work: Dr Holubkov is a paid board member of Pfizer, Inc; Dr Hall is a paid consultant to LaJolla Pharmaceuticals; and Dr Pollack's institute is supported by grants from Mallinckrodt Pharmaceuticals.
Publisher Copyright:
© 2021 American College of Surgeons
PY - 2021/12
Y1 - 2021/12
N2 - Background: Disability and impaired health-related quality of life can persist for months among injured children. Previous studies of long-term outcomes have focused mainly on children with specific injury types rather than those with multiple injured body regions. This study's objective was to determine the long-term functional status and health-related quality of life after serious pediatric injury, and to evaluate the associations of these outcomes with features available at hospital discharge. Study Design: We conducted a prospective observational study at 7 Level I pediatric trauma centers of children treated for at least 1 serious (Abbreviated Injury Scale severity 3 or higher) injury. Patients were sampled to increase the representation of less frequently injured body regions and multiple injured body regions. Six-month functional status was measured using the Functional Status Scale (FSS) and health-related quality of life using the Pediatric Quality of Life Inventory. Results: Among 323 injured children with complete discharge and follow-up assessments, 6-month FSS score was abnormal in 33 patients (10.2%)—16 with persistent impairments and 17 previously normal at discharge. Increasing levels of impaired discharge FSS score were associated with impaired FSS and lower Pediatric Quality of Life Inventory scores at 6-month follow-up. Additional factors on multivariable analysis associated with 6-month FSS impairment included older age, penetrating injury type, severe head injuries, and spine injuries, and included older age for lower 6-month Pediatric Quality of Life Inventory scores. Conclusions: Older age and discharge functional status are associated with long-term impairment of functional status and health-related quality of life. Although most seriously injured children return to normal, ongoing disability and reduced health-related quality of life remained 6 months after injury. Our findings support long-term assessments as standard practice for evaluating the health impacts of serious pediatric injury.
AB - Background: Disability and impaired health-related quality of life can persist for months among injured children. Previous studies of long-term outcomes have focused mainly on children with specific injury types rather than those with multiple injured body regions. This study's objective was to determine the long-term functional status and health-related quality of life after serious pediatric injury, and to evaluate the associations of these outcomes with features available at hospital discharge. Study Design: We conducted a prospective observational study at 7 Level I pediatric trauma centers of children treated for at least 1 serious (Abbreviated Injury Scale severity 3 or higher) injury. Patients were sampled to increase the representation of less frequently injured body regions and multiple injured body regions. Six-month functional status was measured using the Functional Status Scale (FSS) and health-related quality of life using the Pediatric Quality of Life Inventory. Results: Among 323 injured children with complete discharge and follow-up assessments, 6-month FSS score was abnormal in 33 patients (10.2%)—16 with persistent impairments and 17 previously normal at discharge. Increasing levels of impaired discharge FSS score were associated with impaired FSS and lower Pediatric Quality of Life Inventory scores at 6-month follow-up. Additional factors on multivariable analysis associated with 6-month FSS impairment included older age, penetrating injury type, severe head injuries, and spine injuries, and included older age for lower 6-month Pediatric Quality of Life Inventory scores. Conclusions: Older age and discharge functional status are associated with long-term impairment of functional status and health-related quality of life. Although most seriously injured children return to normal, ongoing disability and reduced health-related quality of life remained 6 months after injury. Our findings support long-term assessments as standard practice for evaluating the health impacts of serious pediatric injury.
UR - http://www.scopus.com/inward/record.url?scp=85115926961&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2021.08.693
DO - 10.1016/j.jamcollsurg.2021.08.693
M3 - Article
C2 - 34592405
AN - SCOPUS:85115926961
SN - 1072-7515
VL - 233
SP - 666-675.e2
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 6
ER -