| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
PAPER |
1 Centre for Health Services Studies, University of Warwick, Coventry, UK
2 North Staffordshire Rehabilitation Centre, The Haywood, High Lane, Burslem, Stoke-on-Trent, Staffordshire ST6 7AG, UK
3 Paediatric Intensive Care Unit, City General Hospital, Newcastle Road, Stoke-on-Trent, Staffordshire ST4 6QG, UK
4 North Staffordshire Rehabilitation Centre, The Haywood, High Lane, Burslem, Stoke-on-Trent, Staffordshire ST6 7AG, UK
Correspondence to:
Correspondence to:
Dr C Hawley
Principal Research Fellow, Centre for Health Services Studies, University of Warwick, Coventry CV4 7AL, UK; c.a.hawley{at}warwick.ac.uk
Objectives: To identify outcomes following head injury (HI) among a population of children admitted to one hospital centre and to compare outcomes between different severity groups.
Methods: A postal follow up of children admitted with HI to one National Health Service Trust, between 1992 and 1998, was carried out. Children were aged 5–15 years at injury (mean 9.8), followed up at a mean of 2.2 years post-injury. Parents of 526 injured children (419 mild, 58 moderate, 49 severe) and 45 controls completed questionnaires. Outcomes were assessed using the King’s Outcome Scale for Childhood Head Injury (KOSCHI).
Results: Frequent behavioural, emotional, memory, and attention problems were reported by one third of the severe group, one quarter of the moderate, and 10–18% of the mild. Personality change since HI was reported for 148 children (28%; 21% mild HI, 46% moderate, 69% severe). There was a significant relationship between injury severity and KOSCHI outcomes. Following the HI, 252 (48%) had moderate disability (43% mild HI, 64% moderate, 69% severe), while 270 (51%) made a good recovery (57% mild HI, 36% moderate, 22% severe). There was a significant association between social deprivation and poor outcome (p = 0.002). Only 30% (158) of children received hospital follow up after the HI. All children with severe disability received appropriate follow up, but 64% of children with moderate disability received none. No evidence was found to suggest a threshold of injury severity below which the risk of late sequelae could be safely discounted.
Conclusions: Children admitted with mild HI may be at risk of poor outcomes, but often do not receive routine hospital follow up. A postal questionnaire combined with the KOSCHI to assess outcomes after HI may be used to identify children who would benefit from clinical assessment. Further research is needed to identify factors that place children with mild HI at risk of late morbidity.
Keywords: community; deprivation; head injury; outcomes; long term follow up
Abbreviations: GOS, Glasgow Outcome Scale; HI, head injury; KOSCHI, King’s Outcome Scale for Childhood Head Injury; SEN, special educational needs
This article has been cited by other articles:
|
|
 |
|
  C. Catroppa, V. A. Anderson, S. A. Morse, F. Haritou, and J. V. Rosenfeld Outcome and Predictors of Functional Recovery 5 Years Following Pediatric Traumatic Brain Injury (TBI) J. Pediatr. Psychol., August 1, 2008; 33(7): 707 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kerr, I. J Swann, and B. Pentland A survey of information given to head-injured patients on direct discharge from emergency departments in Scotland Emerg. Med. J., May 1, 2007; 24(5): 330 - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G J Browne and L T Lam Concussive head injury in children and adolescents related to sports and other leisure physical activities Br. J. Sports Med., February 1, 2006; 40(2): 163 - 168. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Muir Hygieia J. Epidemiol. Community Health, September 1, 2005; 59(9): 812 - 812. [Full Text] [PDF]
|
|
|
|
 |
|
 Outcomes after head injury Arch. Dis. Child., September 1, 2004; 89(9): 870 - 870. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
