Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

Abstract

BackgroundSeveral studies have indicated that younger age is associated with worse recovery after pediatric traumatic brain injury (TBI) compared to elder children. In order to verify this association between long-term outcome after moderate to severe TBI and patient’s age, direct comparison between different pediatric age groups as well as an adult population was performed.MethodsThis investigation represents a retrospective cohort study at a level I trauma center including patients with moderate to severe, isolated TBI with a minimum follow-up of 10 years. According to their age at time of injury, patients were divided in pre-school (0–7 years), school (8–17 years) and adult (18–65 years) patients. Physical examination and standardized questionnaire on physical and psychological aspects (Glasgow Outcome Scale, Barthel Index, Impact of Event Scale, Hospital Anxiety and Depression Scale, short form 12) were performed.Results135 traumatized patients were included. Physical and psychological long-term outcome was associated with injury severity but not with patients’ age at time of injury. Outcome recovery measured by Glasgow Outcome Scale was demonstrated with best results for pre-school aged children (p = 0.009). According to the Hospital Anxiety and Depression Scale an increased incidence of anxiety (p = 0.010) and depression (p = 0.026) was evaluated in older patients.ConclusionLong-term outcome perceptions after moderate to severe TBI presented in this study question current views of deteriorated recovery for the immature brain. The sustained TBI impact seemed not to reduce the child’s ability to overcome the suffered impairment measured by questionnaire based psychological, physical and health related outcome scores. These results distinguish the relevance of rehabilitation and family support in the long term.

Increased in-hospital mortality following severe head injury in young children: results from a nationwide trauma registry

“…To analyse age-dependent treatment strategies and in-hospital outcome, the included patients were divided into six subgroups referring to Andruszkow et al [ 13 ]: Group I (“infants”): age 1–3 years. Group II (“pre-school-aged children”): age 4–6 years.…”

Aging with Traumatic Brain Injury: Effects of Age at Injury on Behavioral Outcome following Diffuse Brain Injury in Rats

“…It is possible that the rats injured in adulthood had significant anxiety-like behavior compared to uninjured naïve rats, because the test was administered closer to their time of injury compared to rats injured in childhood (PND 17) and adolescence (PND 35). A recent retrospective clinical study reported no significant correlation between age at injury and psychological outcome parameters [49]. Few studies have evaluated the development of anxiety disorders after TBI, and further studies are necessary to understand the mechanisms of psychopathology among TBI survivors.…”

Ten-to-twelve years after specialized neurorehabilitation of young patients with severe disorders of consciousness: A follow-up study

“…The validity and reliability of the questionnaire was not investigated, although some parts of it (i.e. the Barthel index) are known to be valid and reliable in cases of patients with brain injury [23].…”