Long-Term Quality of Life After Pediatric Traumatic Brain Injury Treated in the Intensive Care Unit.

Health-related quality of life Intensive care Long-term outcome Pediatric Traumatic brain injury

Journal

Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183

Informations de publication

Date de publication:
06 May 2024
Historique:
received: 12 10 2023
revised: 02 03 2024
accepted: 29 04 2024
medline: 13 6 2024
pubmed: 13 6 2024
entrez: 12 6 2024
Statut: aheadofprint

Résumé

To examine the long-term health-related quality of life (HRQL) after pediatric traumatic brain injury (TBI) treated in the intensive care unit (ICU). This retrospective cohort study was conducted using data from four university hospital ICUs in Finland. Children aged < 18 years with TBI treated in the ICU during 2003 to 2013 were included. Patients alive at the end of 2020 were sent two different HRQL questionnaires 15/16-dimensional (15D/16D) and RAND-36  and questions regarding chronic diseases, socioeconomical status, and the need for health care support. HRQL was defined as poor when the 15D/16D score total score was below the age- and sex-matched mean population score in Finland minus the minimal clinically important difference. A total of 150 of 337 (44%) patients responded (n = 144 15D/16D responses). Median follow-up time was 11 years. Seventy patients (49%) had a poor HRQL according to 15D/16D score. Patients with TBI had significantly poorer 15D scores in every dimension when compared with the matched population mean values. A higher Helsinki CT score, mechanical ventilation, and female sex were associated with poor long-term HRQL according to the 15D/16D. Patients with poor 15D/16D scores also needed significantly more health care services and medications and had more comorbidities than patients with normal scores. A poor 15D/16D score was associated with lower socioeconomic status. Half of long-term pediatric ICU-treated TBI survivors had poor HRQL 11 years after injury. More severe head computed tomographic findings at admission and female sex associated with poor HRQL.

Sections du résumé

BACKGROUND BACKGROUND
To examine the long-term health-related quality of life (HRQL) after pediatric traumatic brain injury (TBI) treated in the intensive care unit (ICU).
METHODS METHODS
This retrospective cohort study was conducted using data from four university hospital ICUs in Finland. Children aged < 18 years with TBI treated in the ICU during 2003 to 2013 were included. Patients alive at the end of 2020 were sent two different HRQL questionnaires 15/16-dimensional (15D/16D) and RAND-36  and questions regarding chronic diseases, socioeconomical status, and the need for health care support. HRQL was defined as poor when the 15D/16D score total score was below the age- and sex-matched mean population score in Finland minus the minimal clinically important difference.
RESULTS RESULTS
A total of 150 of 337 (44%) patients responded (n = 144 15D/16D responses). Median follow-up time was 11 years. Seventy patients (49%) had a poor HRQL according to 15D/16D score. Patients with TBI had significantly poorer 15D scores in every dimension when compared with the matched population mean values. A higher Helsinki CT score, mechanical ventilation, and female sex were associated with poor long-term HRQL according to the 15D/16D. Patients with poor 15D/16D scores also needed significantly more health care services and medications and had more comorbidities than patients with normal scores. A poor 15D/16D score was associated with lower socioeconomic status.
CONCLUSIONS CONCLUSIONS
Half of long-term pediatric ICU-treated TBI survivors had poor HRQL 11 years after injury. More severe head computed tomographic findings at admission and female sex associated with poor HRQL.

Identifiants

pubmed: 38865950
pii: S0887-8994(24)00180-2
doi: 10.1016/j.pediatrneurol.2024.04.030
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

50-56

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Kyösti received funding from a Finnish grant for Pediatric Research and Alma and K.A. Snellman foundation. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Auteurs

Elina Kyösti (E)

Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland; Medical Research Center of Oulu University and Oulu University Hospital, Critical Care Center, Oulu, Finland. Electronic address: elina.kyosti@pohde.fi.

Era Mikkonen (E)

Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Emergency Care and Services, Helsinki University Hospital & University of Helsinki, Helsinki, Finland.

Rahul Raj (R)

Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Pasi Ohtonen (P)

Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland; Medical Research Center of Oulu University and Oulu University Hospital, Critical Care Center, Oulu, Finland; Research Service Unit, Oulu University Hospital, Oulu, Finland.

Outi Peltoniemi (O)

Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland; Division of Intensive Care Medicine, Department of Paediatrics, Oulu University Hospital, Oulu, Finland.

Markus B Skrifvars (MB)

Department of Emergency Care and Services, Helsinki University Hospital & University of Helsinki, Helsinki, Finland.

Tero Ala-Kokko (T)

Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland; Medical Research Center of Oulu University and Oulu University Hospital, Critical Care Center, Oulu, Finland.

Classifications MeSH