Health-related quality of life and functional outcome measures for pediatric multiple injury: A systematic review and narrative synthesis

Abstract

BACKGROUND:Pediatric multiple injury is a major cause of mortality and morbidity worldwide, with varied long-term sequelae. To improve care, a better understanding of the outcome tools used following multiple injury is needed. OBJECTIVES:This study aimed to (1) identify the outcome tools used to assess functional and health-related quality of life outcomes in pediatric multiple injury and to (2) describe the tool domains and validity. METHODS:Eligible studies were those that included pediatric participants aged 0 to 17 years who experienced multiple injury or severe trauma based on Injury Severity Score/Abbreviated Injury Scale score and a functional outcome tool was used to assess outcomes (e.g., physical, psychological, quality of life). Excluded study designs were editorials, narrative, and systematic reviews. RESULTS:Twenty-two papers were included encompassing 16,905 participants and 34 different outcome tools. Ten tools were validated in children of which 4 were multiple injury specific; 18 were validated in adults of which 8 were trauma specific, and 6 were previously unvalidated. The tools were a mixture of patient reported (7 of 10 validated in children and 13 of 18 validated in adults) and clinician reported (3 of 10 validated in children and 2 of 13 validated in adults). Pediatric tool domains assessed were function, mobility, activities of daily living, pain, school, cognition, emotional domains, mental health, behavior, and high-risk behaviors.Using adult-validated tools to assess children may not capture the children's true function and health-related quality of life. CONCLUSION:There was a lack of consistency in the outcome tools used following multiple injury in children. Adult-validated measures may not accurately capture pediatric outcomes after multiple injury. To fully understand the impact of pediatric multiple injury and make comparisons between studies, development of a core outcome set is required.

Functional Outcomes at 6 and 12 Months Post-Injury in a Trauma Centre Population with Moderate-to-Severe Traumatic Injuries

“…GOSE scores were obtained through structured clinical interviews at 6 and 12 months post-injury. For children, the harmonised GOSE was used [ 31 ], as the GOSE is the most common trauma-specific adult tool used in children [ 32 ]. In this study, we used the GOSE as a continuous variable, as the scores were normally distributed.…”

The Latest in Resuscitation Research: Highlights From the 2022 American Heart Association’s Resuscitation Science Symposium

“… 64 Collins et al conducted a systematic review and meta‐analysis aimed at identifying outcome tools to assess functional outcomes and health‐related quality of life among pediatric trauma patients. 65 …”