Medical College of Wisconsin
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Brain injury: functional outcome in children with tracheostomies and gastrostomies. Arch Phys Med Rehabil 1989 Apr;70(4):318-21

Date

04/01/1989

Pubmed ID

2930347

Scopus ID

2-s2.0-0024544534 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

Survival, functional outcome, placement, and need for appliances at six and 24 months after either anoxic metabolic encephalopathies (AME) or traumatic head injuries (TI) were determined in 36 children with both tracheostomies and gastrostomies who were discharged from acute care hospitals. Five deaths occurred in totally dependent children with both tracheostomies and gastrostomies in place. Ten of 22 children with TI (48% of survivors) achieved independence in three functional areas by two years, whereas none of 14 with AME achieved functional independence in any area at two years (p = 0.001). Only one of the 18 who were dependent in all three areas at six months achieved partial independence in any area on reevaluation at two years. Institutionalization at two years was strongly predicted by six-month functional status (p less than 0.01). Four of 18 children dependent at six months returned to home care by two years, whereas all 16 children who achieved partial independence within six months of insult were cared for at home at two years (p less than 0.001), regardless of age or injury type. The need for tracheostomy at two years correlated with functional status at six months (p less than 0.01). Two-year survival was unexpectedly high for this group of children when compared to studies in adults. Functional status at six months is a strong predictor of dependency and institutionalization at two years.

Author List

Splaingard ML, Gaebler D, Havens P, Kalichman M



MESH terms used to index this publication - Major topics in bold

Activities of Daily Living
Adolescent
Adult
Brain Injuries
Child
Child, Preschool
Female
Gastrostomy
Humans
Infant
Institutionalization
Male
Prognosis
Retrospective Studies
Time Factors
Tracheostomy