Health status recovery at one year in children injured in a road accident: A cohort study

Abstract

Despite the frequency of traumatic injuries due to road accidents and potential importance of identifying children at risk of impaired recovery one year after a road accident, there is a lack of data on long-term recovery of health status, except in children with severe traumatic brain injury. The aim of the present study was to evaluate predictive factors of recovery in children one year after road traffic injuries. The prospective cohort study was composed of children aged <16 years, admitted to public or private sector hospitals in the Rhône administrative area of France following a road accident. Recovery of health status one year after the accident and information concerning quality of life and the consequences of the accident for the child or family 1 year after the accident were collected by questionnaire, usually completed by the parents. Victims were in majority male (64.6%) and had mild or moderate injuries (81.9% with Maximum Abbreviated Injury Scale (M-AIS) <3). One year after the accident, 75.0% of the mild-to-moderate and 34.8% of the severe cases estimated health status as fully recovered. After adjustment, severity score (M-AIS≥3) and lower limb injury (AIS>1) were associated with incomplete recovery of health status: weighted odds ratio (ORw), 4.3 [95% confidence interval (95% CI), 1.3-14.6] and ORw, 6.5 [95% CI, 1.9-21.7], respectively. Recovery status correlated significantly with quality of life physical scores (r=0.46), especially body pain (r=0.48) and role/social-physical (r=0.50) and, to a lesser extent, quality of life psychosocial scores (r=0.21). In a cohort of children injured in a road accident, those with high injury severity score and those with lower limb injuries are less likely to recover full health status by 1 year. Impaired health status was associated with a lower physical quality of life score at 1 year.

Disparities in Non-Fatal Health Outcomes in Pediatric General Trauma Studies

“…As summarized in Table 4 , only one study (of nine studies assessing variations by sex) found a difference with girls more likely to be lost to follow-up [ 52 ]. The one study examining parental occupation found higher losses to follow-up among children of parents with low occupation level [ 6 ]. The study assessing socio-economic status found loss to follow-up was highest among those in the lowest income quintile [ 43 ].…”

“…More nuanced analyses can also uncover possible interactions between different factors. For example, a Californian study which found no racial/ethnic disparity in mortality for injured children suggested that the unexpected finding was possibly due to insurance coverage being less of a barrier for children in California than for adults and children elsewhere in the United Sates, and because California’s racial diversity led to culturally competent care which delivered better outcomes [ 6 ].…”

“…This burden is disproportionately greater in low- and middle-income countries, and recent evidence suggests that disparities in child injury deaths are worsening in some contexts, including within high-income countries [ 2 ]. Reported disparities in child injury deaths are particularly likely by ethnicity/race, socio-economic status and insurance cover [ 3 , 4 , 5 , 6 , 7 ]. In contrast, the extent to which non-fatal outcomes (e.g., longer-term disability) following childhood injury may vary by sociodemographic factors has received little attention.…”

Maternal and child health after injuries: a two-year follow-up of a nationally representative sample

“…26 McCarthy et al 22 followed up injured children longitudinally and found 40% of those with head injuries to have substantial impairments at 12 months. Another study by Batailler et al 27 among children injured in traffic crashes found that 32.3% of them had not fully recovered at 12 months. Health deficits among children with injuries were also documented in a study by Holbrook et al 28 in which children were followed for 24 months.…”

Use of general life quality questionnaires for assessing the effectiveness of treatment of children with fractures of long bones of the lower extremities: a literature review

“…Изучение этих измене-ний для анализа эффективности лечения и реа-билитации становится все более актуальной за-дачей, а представление результатов исследования с использованием международных показателей эффективности способствует обобщению между-народного клинического опыта. При этом особое значение приобретает внедрение «количествен-ной методики оценки исходов, с известной и до-казанной точностью позволяющей проводить все необходимые статистические операции» в соот-ветствии с принципами доказательной медицины [10,55,56].…”