The association between hospitalisation for childhood head injury and academic performance: evidence from a population e-cohort study

Abstract

BackgroundChildhood head injury has the potential for lifelong disability and burden. This study aimed to establish the association between admission to hospital for childhood head injury and early academic performance.MethodsThe Wales Electronic Cohort for Children (WECC) study is comprised of record-linked routinely collected data, on all children born or residing in Wales. Anonymous linking fields are used to link child and maternal health, environment and education records. Data from WECC were extracted for children born between September 1998 and August 2001. A Generalised Estimating Equation model, adjusted for clustering based on the maternal identifier as well as other key confounders, was used to establish the association between childhood head injury and performance on the Key Stage 1 (KS1) National Curriculum assessment administered to children aged 5–7 years. Head injury was defined as an emergency admission for >24 h for concussion, skull fracture or intracranial injury prior to KS1 assessment.ResultsOf the 101 892 eligible children, KS1 results were available for 90 661 (89%), and 290 had sustained a head injury. Children who sustained an intracranial injury demonstrated significantly lower adjusted odds of achieving a satisfactory KS1 result than children who had not been admitted to hospital for head injury (adjusted OR 0.46, 95% CI 0.30 to 0.72).ConclusionsThe findings of this population e-cohort study quantify the impact of head injury on academic performance, highlighting the need for enhanced head injury prevention strategies. The results have implications for the care and rehabilitation of children admitted to hospital with head injury.

The role of health and social factors in education outcome: A record-linked electronic birth cohort analysis

“…Our review of the literature identified seven previous studies that specifically examined the impact of unplanned hospital inpatient admissions on educational outcome. [1,2,48–52] Consistent with our findings, O’Brien Caughy’s analysis of secondary data in the U.S.A. showed that inpatient hospital admissions during the first year of life was associated with lower scores on reading recognition, partially explained by differences in levels of maternal education and the home environment [1]. Kull et al tested the associations between child development at age five years and indicators of physical health during childhood (including acute conditions and unplanned hospitalisations) in a large national birth cohort of children in Boston U.S.A. [2].…”

“…Evidence from large-scale robust studies in the USA have shown that school absence in the elementary years is associated with poor educational outcomes in reading and mathematics [54–55]. Gabbe et al quantified the impact of inpatient admission for head injury on academic performance in the Wales Electronic Cohort for Children (WECC), showing that children who had sustained an intracranial injury had an increased risk of not attaining the expected level of achievement at age 6–7 years, using the same outcome measure that we used in our analysis [48]. This could be a direct effect of temporary or permanent brain damage or indirect effect of time missed from school.…”

Epidemiological Determinants of Cranioencephalic Trauma in Children

“…No qual é notório que existe uma distribuição trimodal quando se avalia a faixa etária das vitimas, apontando picos principalmente na primeira infância, adolescência tardia e indivíduos com idade superior 60 anos. Quando se analisa a presença de lesões na cabeça na faixa etária infantil é identificada como um agravo com prejuízos no âmbito da saúde pública no qual esta associada principalmente a um elevado potencial de prejuízos ao longo da vida (Gabbe et al,2014).…”

“…Vale salientar que à medida que a criança vai ficando mais ocorrem modificações nesse perfil. 67% dos pacientes eram do sexo masculino, 64,08% com idade entre 01 e 02 anos, sendo a maior parte dos casos considerada um TCE leve.Um estudo de coorte avaliou 290 crianças com idade entre 5 a 7 anos que foram atendidas decorrente de lesões na cabeça, no qual foi possível verificar que 52,7% dos pacientes apresentaram fratura craniana e em 36,8% das admissões foram por lesões intracranianas, no qual existiu uma predominância de crianças com idade inferior a 3 anos, sendo mais comum no sexo masculino(Gabbe et al,2014).…”

“…Outras alterações que podem ocorrer são comprometimento da habilidade motora e sequelas neurocognitivas. Neste contexto, é crucial a introdução de medidas que busquem a diminuição de lesões na cabeça na faixa etária infantil, como também o estabelecimento de estratégias de reabilitação escolar(Gabbe et al,2014).Durante a avaliação de 132 crianças com TCE identificou-se que aproximadamente 80% dos pacientes apresentaram HIC, principalmente em crianças com faixa etária inferior a 4 anos, no qual a monitorização da PIC é fundamental para proporcionar um melhor controle. É importante compreender que o controle adequado é fundamental, especialmente nos casos de HIC refratária no qual esta associada a uma elevada morbimortalidade.…”