Long-term disability after trauma in children

Abstract

Purpose: The aim of this study was to assess long-term disability after pediatric trauma and identify predicting factors.

Methods: A phone survey was conducted of all pediatric trauma patients with an Injury Severity Score (ISS) > or = 4 seen over 6 years at a regional trauma center. The questionnaire was a modification of the Rand Health Insurance Study scales.

Results: Of 218 eligible trauma registry patients, 19 were deceased, 64 unreachable, 19 declined, and 116 interviewed. There were no demographic differences between respondents and nonrespondents. Sixty-three percent of the respondents were boys, mean age at injury was 13, ISS 16.7, and mean interval since injury was 4.4 (range, 1 to 7) years. Sixty-three children (54%) had no limitations on follow-up; the remainder had either limitations in physical or role activities (28%), mobility (16%), or self-care ability (2%). Significant correlations were found between the presence of disability and trauma scores and number of body regions injured. Stepwise logistic regression identified number of regions injured, mechanism of injury, and ISS as the main determinants for presence of long-term disability.

Conclusions: Half of injured children do have long-term sequelae. Their occurrence can be predicted from trauma scores, mechanism of injury, and number of regions injured.