Outcome and Predictors of Functional Recovery 5 Years Following Pediatric Traumatic Brain Injury (TBI)

Catroppa, Cathy; Anderson, Vicki; Morse, Sue; Haritou, Flora; Rosenfeld, Jeffrey V.

doi:10.1093/jpepsy/jsn006

Cited by 231 publications

(193 citation statements)

References 42 publications

Supporting

Mentioning

182

Contrasting

Order By: Relevance

“…Social/behavioral outcomes were predicted by family function, in keeping with previous reports from school-age samples and evaluation more proximal to time of injury. 10,12,15 Apparently, although injury factors, such as severity and brain pathology, are relevant to early outcome, they become less important with time since injury.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Few studies, however, have prospectively followed survivors of early TBI into adolescence, and those available focus primarily on cognition. In addition, several factors have been identified that contribute to deficits after school-aged TBI (injury severity and age, premorbid child and family function), [9][10][11][12][13] but it is unclear whether these factors also explain outcomes for younger children.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

et al. 2012

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery. METHODS: Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined. RESULTS: Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills). CONCLUSIONS: Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about “growing into deficits,” after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Of the 23 full text papers reviewed, 13 were excluded either because they were not studies that had developed or evaluated risk prediction models for TBI or because the models included predictors measured outside of the hospital, leaving 10 studies published since 2006 (reporting 78 models) meeting the Perel and colleagues inclusion criteria. 22,27,30,[35][36][37]39,40,42,43 Of these 10 studies, eight did not fulfil the RAIN Study eligibility criteria-because the models had been developed in pediatric populations (n = 3), were based on samples of fewer than 500 patients (n = 6), adjusted for care received within hospital (n = 1), or had been conducted in a single-center, non-UK setting (n = 6)-resulting in two eligible studies (reporting 14 models). 35,40 Additionally including the two studies reporting the most clinically useful models from the original systematic review resulted in four studies (reporting 17 models) for review by the RAIN Study Steering Group-the models of Signorini and colleagues (1999), The RAIN Study Steering Group did not identify any further studies, either published or ongoing, that would be potentially eligible for the RAIN Study (date of meeting, April 17, 2009).…”

Section: Selection Of Risk Prediction Modelsmentioning

confidence: 99%

External Validation and Recalibration of Risk Prediction Models for Acute Traumatic Brain Injury among Critically Ill Adult Patients in the United Kingdom

Harrison

Griggs

Prabhu

et al. 2015

Journal of Neurotrauma

View full text Add to dashboard Cite

This study validates risk prediction models for acute traumatic brain injury (TBI) in critical care units in the United Kingdom and recalibrates the models to this population. The Risk Adjustment In Neurocritical care (RAIN) Study was a prospective, observational cohort study in 67 adult critical care units. Adult patients admitted to critical care following acute TBI with a last pre-sedation Glasgow Coma Scale score of less than 15 were recruited. The primary outcomes were mortality and unfavorable outcome (death or severe disability, assessed using the Extended Glasgow Outcome Scale) at six months following TBI. Of 3626 critical care unit admissions, 2975 were analyzed. Following imputation of missing outcomes, mortality at six months was 25.7% and unfavorable outcome 57.4%. Ten risk prediction models were validated from Hukkelhoven and colleagues, the Medical Research Council (MRC) Corticosteroid Randomisation After Significant Head Injury (CRASH) Trial Collaborators, and the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) group. The model with the best discrimination was the IMPACT ''Lab'' model (C index, 0.779 for mortality and 0.713 for unfavorable outcome). This model was well calibrated for mortality at six months but substantially under-predicted the risk of unfavorable outcome. Recalibration of the models resulted in small improvements in discrimination and excellent calibration for all models. The risk prediction models demonstrated sufficient statistical performance to support their use in research and audit but fell below the level required to guide individual patient decision-making. The published models for unfavorable outcome at six months had poor calibration in the UK critical care setting and the models recalibrated to this setting should be used in future research.

show abstract

“…10,11 Family problemsolving therapy (FPST) has emerged as a potentially efficacious treatment of reducing behavioral and executive dysfunction after TBI in adolescents. [5][6][7][12][13][14][15] Family functioning contributes to recovery after TBI [16][17][18][19] ; thus, interventions promoting family problem-solving may improve the child's behavior and functioning.…”

Section: Pediatrics Volume 135 Number 2 February 2015mentioning

confidence: 99%

Online Problem-Solving Therapy After Traumatic Brain Injury: A Randomized Controlled Trial

2015

PEDIATRICS

View full text Add to dashboard Cite

BACKGROUND: Pediatric traumatic brain injury (TBI) contributes to impairments in functioning in everyday settings. Evidence suggests that online family problem-solving therapy (FPST) may be effective in reducing adolescent behavioral morbidity. This article examines the efficacy of Counselor-Assisted Problem Solving (CAPS), a form of online FPST in improving long-term functional outcomes of adolescents with TBI relative to Internet resources only.

show abstract

Outcome and Predictors of Functional Recovery 5 Years Following Pediatric Traumatic Brain Injury (TBI)

Abstract: Children who sustain a severe TBI in early childhood are at greatest risk of long-term impairment in day-to-day skills in the long-term postinjury.

Cited by 231 publications

References 42 publications

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

External Validation and Recalibration of Risk Prediction Models for Acute Traumatic Brain Injury among Critically Ill Adult Patients in the United Kingdom

Online Problem-Solving Therapy After Traumatic Brain Injury: A Randomized Controlled Trial

Contact Info

Product

Resources

About