Functional status after childhood traumatic brain injury.

J Trauma. 2006 May;58(5):940-9; discussion 950.

Wechsler B, Kim H, Gallagher PR, DiScala C, Stineman MG.

Rehabilitation Program, Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland, Ohio 44104, USA.

BACKGROUND: Identification of children after traumatic brain injury (TBI) likely to have functional deficits at trauma center discharge will facilitate care.

METHODS: Two logistic regression models were derived from data on 4,439 children after TBI 7 to 14 years old enrolled in the National Pediatric Trauma Registry between 1994 and 2001 to predict physical and cognitive disabilities.

RESULTS: Children with open or multiple fractures or closed fractures or injured by motor vehicles were 8.2, 3.5, or 2.5 times more likely, respectively, than those without those circumstances to have discharge physical disabilities. Likelihood of cognitive impairment was increased by factors of 3.2 and 5.8 in children obtunded or comatose on arrival. Preexisting cognitive deficits, injury severity, and intubation predicted physical and cognitive disabilities. The C statistic was 0.862 for the motor model and 0.860 for the cognitive model.

CONCLUSION: Predicting the likelihood of morbidity after acute management of childhood TBI can provide information pertinent to providing effective care.