Development of a novel method to predict disability after head trauma in children. J Pediatr Surg 2003 Mar;38(3):482-5
Date
03/13/2003Pubmed ID
12632372DOI
10.1053/jpsu.2003.50084Scopus ID
2-s2.0-0037370341 (requires institutional sign-in at Scopus site) 12 CitationsAbstract
BACKGROUND/PURPOSE: Although analysis of functional independence measures (FIM) at discharge are useful for assessing extent of disability in head-injured children, there is no reliable method to predict the severity of disability at the time of admission. The authors developed a novel method to predict severe disability after head trauma on admission.
METHODS: Head-injured patients, 2 to 16 years old, with FIM recorded at discharge (n = 3,491) were identified in our state trauma database for the period from 1993 through 1996. Patients categorized as completely dependent by one or more of the FIM (Feeding, Locomotion, Expression, Transfer Mobility, Social Interaction) were classified as disabled. Probability of disability (P(D)) was estimated based on regression weights for Glasgow Coma Scale (GCS), Injury Severity Score (ISS), age, and number of anatomic regions injured. Observed to expected disability rates were compared using a test data set of 2,553 patients entered in the database between 1997 through 1999.
RESULTS: There was no statistically significant difference between observed and expected disability across all P(D) intervals, which suggests that the P(D) accurately predicted disability.
CONCLUSIONS: P(D) offers a novel and reliable method for early prediction of likelihood of disability in children who sustain head trauma. Routine use of the P(D) may lead to earlier intervention to improve long-term results in head-injured children.
Author List
Cassidy LD, Potoka DA, Adelson PD, Ford HRAuthor
Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Activities of Daily LivingAdolescent
Brain Damage, Chronic
Child
Child, Preschool
Craniocerebral Trauma
Disabled Children
Female
Glasgow Coma Scale
Humans
Male
Multivariate Analysis
Patient Admission
Pennsylvania
Probability
Reproducibility of Results
Risk Factors
Trauma Centers
Trauma Severity Indices
Treatment Outcome
