- 作者：Sarah R. Risen ; MD1 ; 2 ; Stacy J. Suskauer ; MD1 ; 3 ; 4 ; suskauer@kennedykrieger.org" class="auth_mail ; Ellen J. DeMatt5 ; Beth S. Slomine ; PhD1 ; 3 ; 6 ; Cynthia F. Salorio ; PhD1 ; 3 ; 6
- 关键词：DFQ ; Developmental Functional Quotient ; EL ; Expressive language ; GCS ; Glasgow Coma Scale ; IA ; Independent ambulation ; ICP ; Intracranial pressure ; LOS ; Length of stay in a rehabilitation facility ; TBI ; Traumatic brain injury ; TTA ; Time from injury to admission to inpatient rehabilitation (time of acute hospitalization) ; WeeFIM ; Functional Independence Measure for children
- 刊名：The Journal of Pediatrics
- 出版年：March, 2014
- 年：2014
- 卷：164
- 期：3
- 页码：613-619.e2
- 全文大小：173 K
Objective
To compare clinical features and functional outcomes of age- and sex-matched children with abusive and nonabusive head trauma receiving inpatient rehabilitation.Study design
Children with abusive head trauma (n = 28) and age- and sex-matched children with nonabusive head trauma (n = 20) admitted to an inpatient pediatric rehabilitation unit from 1995-2012 were studied. Acute hospitalization and inpatient rehabilitation records were retrospectively reviewed for pertinent clinical data: initial Glasgow Coma Scale score, signs of increased intracranial pressure, neuroimaging findings, and presence of associated injuries. Functional status at admission to and discharge from inpatient rehabilitation was assessed using the Functional Independence Measure for Children. Outcome at discharge and outpatient follow-up were described based on attainment of independent ambulation and expressive language.
Results
Children with abusive and nonabusive head trauma had similar levels of injury severity, although associated injuries were greater in those with abusive head trauma. Functional impairment upon admission to inpatient rehabilitation was comparable, and functional gains during inpatient rehabilitation were similar between groups. More children with nonabusive than with abusive head trauma attained independent ambulation and expressive language after discharge from rehabilitation; the difference was no longer significant when only children aged >12 months at injury were examined. There was variability in delay to obtain these skills and in the quality of gained skills in both groups.
Conclusions
Despite more associated injuries, children with abusive head trauma make significant functional gains during inpatient rehabilitation, comparable with an age- and sex-matched sample with nonabusive head trauma. Key functional skills may be gained by children in both groups following discharge from inpatient rehabilitation.