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Child Outcomes and Family Characteristics 1 Year After Severe Inflicted or Noninflicted Traumatic Brain Injury

机译:严重外伤性或非外伤性脑损伤后一年的儿童结果和家庭特征

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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 ~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, ~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.
机译:目的。评估幼儿严重外伤性脑损伤(TBI)1年后的结局,并比较受伤和未受伤的孩子之间的结局。研究设计。前瞻性队列研究方法在2000年1月至2001年12月之间在该州的9个重症监护病房中的任何医院住院且在第二个生日当天或之前发生严重TBI的幸存者中,所有北卡罗莱纳州居住的儿童都有资格参加。儿童健康状况,儿童对辅助医疗资源的使用以及家庭特征是通过产妇护理员在受伤后约1年的访谈来确定的。根据伤害类型对家庭特征和儿童结局进行比较。在112名幸存者中完成了对孕产妇看护者的72次访谈(占64.3%)。根据儿科结果表现类别和Stein-Jessup功能状态II(修订)工具的测量,受伤的儿童(n = 41)比未受伤的儿童(n = 31)更差。但是,约50%的受伤儿童只有轻度的缺陷或更好的缺陷。遭受伤害的儿童更多地使用了辅助医疗资源。照料孩子的家庭没有实质性差异,有很大一部分单身,在职的少数族裔母亲。受伤1年后,患有TBI的儿童比其他患有TBI的儿童的结局更差。但是,这些孩子的结局比以前报道的要好。严重的TBI后照顾孩子的许多家庭在社会上处于不利地位。改善儿童结局的干预措施可能包括增加家庭支持。

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