Health Status of Children After Admission for Injury

Aitken, Mary E.; Tilford, John M.; Barrett, Kathleen; Parker, James G.; Simpson, Pippa; Landgraf, Jeanne M.; Robbins, James M.

doi:10.1542/peds.110.2.337

Cited by 57 publications

(64 citation statements)

References 19 publications

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“…Other studies also found that young injury victims reported a reasonably good long-term health state. 7,33 Aitken et al 16 studied the health state of children after admission for an injury with the child health questionnaire and found that after 6 months, 28% of children reported some limitations, which is somewhat higher than the 21% of admitted children with limitations after 5 months resulting from our research. Because the child health questionnaire measures health over 14 domains, it might be more sensitive for limitations than the EQ-5D, which possibly explains the higher prevalence of limitations.…”

Section: Discussioncontrasting

confidence: 60%

“…[11][12][13][14][15] Few studies have described the impact of injuries on the health status of children with both minor and major injuries over time with a generic quality-of-life measure. 7,16 This article describes a large follow-up study in injured children who were aged 5 to 14 years and had visited an emergency department in the Netherlands. This study is an extension of an earlier follow-up study on functional outcome of injured people who were aged 15 years and older with a similar design.…”

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confidence: 99%

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Prevalence and Prognostic Factors of Disability After Childhood Injury

et al. 2005

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ABSTRACT. Objective. To assess the prevalence and the prognostic factors of disabilities after minor and major childhood injuries and to analyze which sociodemographic and injury-related factors are predictive for suboptimal functioning in the long term.Method. We conducted a patient follow-up study in a stratified sample of 1221 injured children who were aged 5 to 14 years and had visited an emergency department in the Netherlands. Our study sample was stratified so that severe, less common injuries were overrepresented. Postal questionnaires were sent 2.5, 5, and 9 months after the injury. We gathered injury and external cause data, sociodemographic information, and data on functional outcome with a generic health status measure EuroQol (EQ-5D) with an additional cognitive dimension. A nonresponse analysis was performed by multivariate logistic regression, and the data were adjusted for nonresponse and the sample stratification. We performed bootstrap analysis to estimate the prevalence of disability in terms of the EQ-5D summary score and the occurrence of limitations in separate health domains: mobility, self-care, usual activities, pain/discomfort, anxiety/depression, and cognition. Respondents also rated their own health state on a visual analog scale, between 0 (worst imaginable health state) and 100 (best imaginable health state). We analyzed the relationship between functional outcome and sociodemographic (age and gender) and injury-related determinants (type of injury, external cause, multiple injury, admission to hospital, and length of stay) by logistic regression analysis.Results. Response rates with respect to the original sample were 43%, 31%, and 30%, respectively. A total of 37% of the children were admitted to the hospital. The mean age of the children was 9.6 years. In two thirds (65%) of the cases, the injury was attributed to a home and/or leisure injury. The health status of injured children improved from 0.92 (EQ-5D summary score) at 2.5 months to 0.96 at 5 months and 0.98 at 9 months. Of all injured children, 26% had at least 1 functional limitation after 2.5 months, 18% after 5 months, and 8% still experienced functional limitations after 9 months. After 2.5 months, lower extremity fractures and other injuries (eg, spinal cord injury, injury of the nerves) demonstrated the worst functional outcome. Independent of the type of injury, our sample of injured children generally showed good recovery between 2.5 and 9 months. The highest prevalence of dysfunction after 9 months existed for pain/discomfort (7%) and usual activities (5%). Hospital admission (odds ratio: 3.6 -5.8) and female gender (odds ratio: 3.0) were predictive for long-term disability. Girls reported more problems for all health domains (except self-care) compared with boys after 9 months, which was also confirmed by the visual analog scale score for selfrelated health (89 for girls vs 95 for boys). Almost one fifth of injured children with a hospital stay of >3 days still had pain and problems with usual activities 9 months ...

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Section: Discussioncontrasting

confidence: 60%

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confidence: 99%

Prevalence and Prognostic Factors of Disability After Childhood Injury

et al. 2005

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“…1,2 In 1998, injuries accounted for 5,189 deaths in U.S. children ages 1 to 15 years (40% of all mortality in this age group). 3 Deaths are the gravest outcome of injury, but they represent only a fraction of the childhood injury burden.…”

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confidence: 99%

Residential Injuries in U.S. Children and Adolescents

et al. 2005

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SYNOPSISObjectives. Injuries are the leading cause of death and disability for U.S. children, but little research exists on injury in the home environment. The purpose of this study was to estimate the rate and severity of and trends in unintentional residential injury for U.S. children Ͻ20 years for 1993-1999.Methods. Data on emergency department (ED) visits were obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Rates and 95% confidence intervals (CIs) were calculated using SUDAAN. Chi-square analysis was used to test for differences among proportions. Time trends were analyzed using linear regression.Results. Residential injuries accounted for an average of 4.01 million (95% CI 3.50 million, 4.56 million) ED visits each year for U.S. children, representing 39% of unintentional injury ED visits. There were an average of 531,000 (95% CI 456,000, 606,000) visits with moderate-to-severe injuries, resulting in 73,680 (95% CI 59,715, 87,645) hospital admissions annually. The rate of residential injury visits (excluding unknown locations) was 5.6 per 100 (95% CI 4.9 per 100, 6.4 per 100). The visit rates for children Ͻ5 years of age were higher than those for children Ͼ9 years (pϽ0.0001). Males had a higher rate of visits than females (pϭ0.01). Falls were the leading mechanisms, resulting in 1.5 million ED visits per year (95% CI 1.3 million, 1.8 million). Residential injury rates decreased by 28% over time (pϽ0.02), from 6.3 per 100 (95% CI 3.4, 9.2) in 1993 to 4.5 per 100 (95% CI 2.3, 6.7) in 1999.Conclusions. The predominant location of injury for U.S. children is the home, accounting for 4.01 million ED visits and more than 70,000 hospitalizations each year. Efforts targeted to the home environment are needed to reduce morbidity and mortality from unintentional injury in U.S. children.

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“…Death, the gravest outcome of injury, represents a considerable fraction of severe childhood injury burden [1]. On the other hand, nonfatal injury was the leading cause of both temporary and permanent disability for patients 19 years and younger [2] and which accounted for a major proportion of health service utilization in children.…”

Section: Introductionmentioning

confidence: 99%

Impact of Trauma System Preparedness on the Outcomes of Severe Injuries Among Child Populations

Afifi

2012

Indian J Surg

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Severe child trauma poses a heavy burden upon the public's health and the nations' economies, in terms of mortality, morbidity, and disability. The burden varies by the maturity level of the adopted trauma system. This work aimed to identify the impact of trauma system maturity on the outcomes of care of severely injured children. Discharge data for the hospitalized trauma children in Florida (mature trauma system) and Indiana (immature trauma system) were retrospectively analyzed. All severely injured children, 1-15 years of age with an injury severity score ≥25 during 1999-2000 were included. Assessment involved the differences in specified treatment procedures, survival rates, hospital length of stay, and the need for post-hospital institutional care. Analysis revealed that Indiana children significantly stay longer in hospital, and that no differences in the rates of patient mortality, discharge-home, and selected procedures were found. Trauma system maturity impacts the volume and complexity of interventions, as well as the mortality, morbidity, and disability associated with severe children and adolescent trauma. The cost of such burden could be directed to improving the quality of the state's injury management services.

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Health Status of Children After Admission for Injury

Cited by 57 publications

References 19 publications

Prevalence and Prognostic Factors of Disability After Childhood Injury

Prevalence and Prognostic Factors of Disability After Childhood Injury

Residential Injuries in U.S. Children and Adolescents

Impact of Trauma System Preparedness on the Outcomes of Severe Injuries Among Child Populations

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