Health-related quality of life during the first year after traumatic brain injury
Health-related quality of life during the first year after traumatic brain injury
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DOI：
10.1001/archpedi.160.3.252
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发表时间：
2006-03-01
影响因子：
--
通讯作者：
Ding, R
中科院分区：
文献类型：
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作者：
McCarthy, ML;MacKenzie, EJ;Ding, R
目的：记录创伤性脑损伤 (TBI) 儿童的健康相关生活质量 (HRQOL)，并检查创伤性脑损伤 (TBI) 儿童的健康相关生活质量 (HRQOL)，并检查损伤后第一年 TBI 严重程度与 HRQOL 之间的关系。设计：前瞻性队列研究。设置：四个儿科 I 级创伤中心。患者：TBI 儿童 (n=330)。主要暴露：创伤性脑损伤。主要结果指标：主要护理人员在基线、3 个月、 12 个月内使用儿科生活质量量表衡量孩子的 HRQOL。使用纵向多变量回归将 HRQOL 结果建模为伤害、患者特征和家庭特征的函数。结果：相当一部分儿童在受伤后 3 个月（42% 的儿童）和 12 个月（40% 的儿童）时 HRQOL 受损。中度或重度 TBI 儿童的 HRQOL 多个维度受到负面影响（从 3.7 下降到 17.6）（P < .05），并且随着时间的推移并没有显着改善。伴随的下肢骨折和脊柱损伤导致总体 HRQOL 大幅下降，特别是在受伤后 3 个月（分别下降 12.9 和 8.1）（P < .05）。 HRQOL 分数还因先前存在的心理社会状况（下降 2.9 至 12.3）、家庭功能受损（下降 5.1 至 6.8）、有医疗补助覆盖或没有保险（下降 3.1 至 5.5）以及单亲家庭（下降 3.2 至 3.4）（P < .05）而降低。结论：中度或重度 TBI导致儿童受伤后 HRQOL 显着下降。与受伤后第一年的患者和家庭特征相比，受伤相关因素对 HRQOL 的影响更大。
Objectives: To document health-related quality of life (HRQOL) of children with traumatic brain injury (TBI) and to examine the relationship between TBI severity and HRQOL during the first year after injury.Design: Prospective cohort study.Setting: Four pediatric level I trauma centers.Patients: Children with TBI (n=330).Main Exposure: Traumatic brain injury.Main Outcome Measures: A primary caregiver completed telephone interviews at baseline, 3 months, and 12 months to measure the child's HRQOL using the Pediatric Quality of Life Inventory. The HRQOL outcomes were modeled as a function of injury, patient characteristics, and family characteristics using longitudinal, multivariable regression.Results: A considerable proportion of children had impaired HRQOL at 3 months (42% of children) and 12 months (40% of children) after injury. Multiple dimensions of HRQOL were negatively affected among children with moderate or severe TBI (decrease of 3.7 to 17.6) (P < .05) and did not improve significantly over time. Concomitant lower extremity fractures and spinal injuries resulted in large declines in overall HRQOL, particularly at 3 months after injury (decrease of 12.9 and 8.1, respectively) (P < .05). The HRQOL scores were also reduced by preexisting psychosocial conditions (decrease of 2.9 to 12.3), impaired family functioning (decrease of 5.1 to 6.8), having Medicaid coverage or being uninsured (decrease of 3.1 to 5.5), and single-parent households (decrease of 3.2 to 3.4) (P < .05).Conclusions: Moderate or severe TBI resulted in measurable declines in children's HRQOL after injury. Injury-related factors impacted HRQOL more compared with patient and family characteristics during the first year after injury.