Health-Related Quality of Life and Function after Paediatric Injuries in India: A Longitudinal Study

Abstract

Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality of life in a prospective cohort study of 373 children admitted to three hospitals in Chandigarh and Haryana states in India. The Pediatric Quality of Life Inventory (PedsQL) and King's Outcome Scale for Childhood Head Injury (KOSCHI) were administered at baseline (pre-injury) and at 1, 2, 4, and 12 months post-injury by telephone interview. Follow-up at all-time points was completed for 277 (77%) of all living participants. Less than one percent reported ongoing disability at 4 months, and no disability was reported at 12 months. PedsQL physical health scores were below healthy child norms (83.4) at 1 month in the cohort for ages 8-12 years and 13-16 years. Although injuries are prevalent, ongoing impact on functioning and disability from most childhood injuries at 12 months was reported to be low. The results raise questions about reliability of generic, Western-centric tools in low- and middle-income settings, and highlight the need for local context-specific tools.

Keywords: paediatric; quality of life; trauma.

Figure 1

Flow chart of prospective cohort study. PedsQL: Pediatric Quality of Life Inventory; KOSCHI: King’s Outcome Scale for Childhood Head Injury.

Figure 2

PedsQL mean estimates for children aged 2–16 years at baseline, 1, 2, 4, and 12 months after injury (n = 386); p < 0.007 comparison to population norms.