Epidemiology of traumatic brain injury in children 15 years and younger in South-Eastern Norway in 2015–16. Implications for prevention and follow-up needs

Dahl, Hilde Margrete; Anđelić, Nada; Løvstad, Marianne; Holthe, Ingvil Laberg; Hestnes, Morten; Diseth, Trond H.; Myhre, Mia Cathrine

doi:10.1016/j.ejpn.2021.02.002

Cited by 14 publications

(13 citation statements)

References 27 publications

(56 reference statements)

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“…Self-and parent-reported HRQOL (PedsQL) scores are presented in Table 6. Overall, HRQOL was comparable to healthy children in other studies (4,59,63,64). However, school functioning was the lowest parent-reported mean (74.51) and slightly lower than the healthy sample reported by Ilmer et al (78.2).…”

Section: Health-related Quality Of Life (Hrqol)supporting

confidence: 70%

“…An overrepresentation of boys is commonly found after pTBI (2,4), and also in the current sample (68%). The study sample was skewed toward the severe end of the severity spectrum, with 15.4% of the injuries classified as severe and 21.2% as moderate.…”

Section: Demographic and Injury Characteristicssupporting

confidence: 60%

“…The pediatric GCS was used for children below 3 years (43). Mild TBI (mTBI) was further classified as uncomplicated or complicated depending on evidence of traumarelated intracranial abnormalities on CT or MRI (4,44). Brain injury severity was also assessed with the Abbreviated Injury Scale (AIS), using the brain injury AIS score (45,46).…”

Section: Severitymentioning

confidence: 99%

“…International incidence estimates are difficult to interpret, due to differences in data sources, case definitions, and age range of included samples (1), with estimates ranging from 12 per 1,00,000 in Sweden to 70-75 per 1,00,000 in Australia and USA (2,3). In Norway, the incidence of hospital-admitted pTBI has recently been found to be 29 per 1,00,000 across severities in the Oslo region (4), and only 2.4 and 2.5 per 1,00,000 for moderate and severe injuries, respectively, in Mid-Norway (5).…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

et al. 2022

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Descriptions of clinical outcomes in pediatric traumatic brain injury (pTBI) in Scandinavia are sparse. The Oslo site of the European CENTER-TBI study has performed a pTBI outcome study in a hospitalized population. The main objective was to investigate neuropsychological outcomes, self- and parent-reported symptoms associated with brain injury, and quality of life in children aged 1–15 years, 5–8 months after injury. Fifty-two children were included, and 45 completed the assessments. The sample consisted of 15.4% severe, 21.2% moderate, and 63.4% mild TBI. Subjectively experienced problems with concentration and fatigue were reported by the parents of nearly half of the children. Higher brain injury symptom load was associated with lower quality of life, but was unrelated to injury severity. Group average scores of the sample on neuropsychological testing appeared unimpaired relative to normative means aside from lower performance in working memory. However, based on an impairment index (i.e., 2 or more tests being >1.5 SD below the normative mean), the presence of weak cognitive performance was evident in as many as 45.4% of the sample. Two-thirds of the sample also showed abnormally large intraindividual variability in cognitive functioning (i.e., significant WISC-IV index discrepancies). The findings highlight the need to look beyond group averages on neuropsychological testing. Utilizing an impairment index and considering intraindividual performance variability conveyed deficits that may warrant clinical follow-up. The association of brain injury symptoms with quality of life but not injury severity emphasizes the need to consider symptoms after TBI within a biopsychosocial framework.Clinical Trial Registration:ClinicalTrials.gov; identifier: NCT02210221.

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Section: Health-related Quality Of Life (Hrqol)supporting

confidence: 70%

Section: Demographic and Injury Characteristicssupporting

confidence: 60%

Section: Severitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

et al. 2022

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“…As the precise prevalence and incidence of pABI in Norway is not known, we have established eligibility estimates based on Norwegian and international research regarding the largest subgroups to estimate. In the greater Oslo region (South-Eastern health region), an estimated 105 children per year acquire a brain injury or insult: approximately 35 acquire a TBI (mild TBI not verified by CT or MRI excluded) [ 73 , 74 ] approximately 22 suffer from cancer in the central nervous system [ 75 ], approximately 48 children receive a diagnosis of encephalitis [ 76 , 77 ], and approximately 18 children experience a stroke each year (perinatal stroke excluded) [ 78 ]. About one-third of the surviving children are expected to experience unmet health care needs more than 1 year after injury/insult [ 79 , 80 ].…”

Section: Methodsmentioning

confidence: 99%

Rehabilitation for children with chronic acquired brain injury in the Child in Context Intervention (CICI) study: study protocol for a randomized controlled trial

Rohrer-Baumgartner

Holthe

Svendsen

et al. 2022

Trials

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Background Pediatric acquired brain injury (pABI) is associated with long-term cognitive, behavioral, social, and emotional problems, which may affect the quality of life, school, and family functioning. Yet, there is a lack of evidence-based community-centered rehabilitation programs for chronic pABI and these children do not systematically receive comprehensive rehabilitation. The Child In Context Intervention (CICI) study is a pragmatic randomized controlled trial (RCT) for children with chronic pABI, which aims to evaluate the effectiveness of an individualized and goal-oriented intervention targeting everyday functioning of the child and family. Methods Children aged 6–16 years with MRI/CT-verified intracranial abnormalities will be included in the CICI study if they have persistent self- or parent-reported cognitive, emotional, and/or behavioral challenges 1 year or more after insult and attend school regularly. A total of 70 families will be randomized 1:1 to an intervention or a control group. The intervention consists of seven family sessions, one parent seminar, and four school sessions delivered over approximately 6 months. The parent seminar will be held in person, and the other sessions will mainly be video based. The children’s and families’ self-reported major challenges in everyday life will be targeted using SMART goals. Evidence-based strategies, when available, will be applied to achieve the goals, combined with psychoeducation. Goal attainment scaling (GAS) will be used to evaluate goal attainment. Data is collected at baseline and after approximately 6 and 9 months. External assessors are blinded to group allocation. Primary outcomes are parent-reported brain injury symptoms in children and parenting self-efficacy at 9 months of follow-up. Secondary outcomes include child-reported brain injury symptoms, quality of life, executive functioning in daily life, parent emotional symptoms, family functioning, and unmet family health care needs. A process evaluation will be conducted. Discussion The current study provides an innovative approach to rehabilitation for children in the chronic phase of ABI and their families. This complex intervention may contribute to the development of evidence-based, high-quality rehabilitation for a large patient group, which is underrepresented in clinical research. It may also improve collaboration between specialized rehabilitation facilities, schools, and local health care services. Inclusion for the trial started in April 2021. Trial registration ClinicalTrials.govNCT04798859. Registered on March 15, 2021

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Rehabilitation of Children with Traumatic Brain Injury

Alexiou

Zika

2022

Pediatric Neurosurgery for Clinicians

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Epidemiology of traumatic brain injury in children 15 years and younger in South-Eastern Norway in 2015–16. Implications for prevention and follow-up needs

Cited by 14 publications

References 27 publications

Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

Rehabilitation for children with chronic acquired brain injury in the Child in Context Intervention (CICI) study: study protocol for a randomized controlled trial

Rehabilitation of Children with Traumatic Brain Injury

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