The King's Outcome Scale for Childhood Head Injury and injury severity and outcome measures in children with traumatic brain injury

Abstract

The aim of this study was to relate discharge King's Outcome Scale for Childhood Head Injury (KOSCHI) category to injury severity and detailed outcome measures obtained in the first year post‐traumatic brain injury (TBI). We used a prospective cohort study. Eighty‐one children with TBI were studied: 29 had severe, 15 moderate, and 37 mild TBI. The male:female ratio was 1.8:1. The mean age was 11 years 10 months (SD 3.6, range 5–16y). Discharge KOSCHI categories were good (n=34), moderate (n=39), severe (n=6), and unclassifiable (n=2). KOSCHI category correlated strongly with admission Glasgow Coma Score, length of hospital stay, and post‐traumatic amnesia. It also correlated significantly with Verbal IQ and Performance IQ (Wechsler); measures of attention; health status (Health Utilities Index [HUI]); health‐related quality of life (Pediatric Quality of Life Inventory [PedsQL]); depressive symptoms (Birleson Depression Scale) assessed within 3 months postTBI; and with Verbal IQ, selective attention (map mission), and HUI and PedsQL domains assessed at least 6 months post‐TBI discharge. KOSCHI did not correlate with behaviour or executive function. We conclude that the KOSCHI scored at hospital discharge correlates with severity of injury and some cognitive, health status, and HRQL outcomes early after TBI. It is not helpful at predicting later difficulties, or behavioural and emotional problems.

Early clinical indicators of developmental outcome in abusive head trauma

“…The Glasgow Coma Outcome Scale has outcome measures that are not applicable to children, such as return to work [36]. The King's Outcome Scale for Childhood Head Injury predicted early outcome well but did not correlate well with long-term outcome, including developmental follow-up [15].…”

“…There is reluctance to make predictions of outcome following AHT in children due to the perceived potential for brain remodeling [8,9,13]. There have been some efforts to correlate outcome with scales performed at admission or at discharge; however, the results have not demonstrated good prediction of long-term development [14,15]. This study correlates developmental outcome of children with AHT to the following objective predictors: presence or absence of seizures, presence or absence of intubation, and presence or absence of a pediatric intensive care admission.…”

Recommendations for the Use of Common Outcome Measures in Pediatric Traumatic Brain Injury Research

“…Child self-report forms have been designed and validated for ages 5-18 years and parent proxy report forms are available for children ages 2-18 years. It has been used in pediatric TBI (Aitken et al, 2009;Calvert et al, 2008;Curran et al, 2003;Erickson et al, 2010;McCarthy et al, 2005, Moon et al, 2010Slomine et al, 2006) and has been translated into over 48 languages including Spanish. Administration time is * 5 min.…”

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

“…The WPTAS was normed on hospitalized children who had not suffered a head injury (Marosszeky et al, 1993) and was found to be suitable for children ≥ 8 years of age in that 94% of these children met the WPTAS pass criteria. The duration of PTA measured by the WPTAS was found to be related (Kendall's Tau = −.32) to the functional outcome in children at discharge (Calvert et al, 2008). To date, other psychometric features of the WPTAS for children have not been established.…”