Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina: A Multicenter Randomized Controlled Trial.
Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina: A Multicenter Randomized Controlled Trial.
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DOI：
10.1097/pcc.0000000000000772
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发表时间：
2016-07
期刊：
影响因子：
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通讯作者：
Vanella EE
中科院分区：
文献类型：
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作者：
Carney NA;Petroni GJ;Luján SB;Ballarini NM;Faguaga GA;du Coudray HE;Huddleston AE;Baggio GM;Becerra JM;Busso LO;Dikmen SS;Falcone R;García ME;González Carrillo OR;Medici PL;Quaglino MB;Randisi CA;Sáenz SS;Temkin NR;Vanella EE
与创伤性脑损伤（TBI）儿童的家庭合作，制定有效，简单和可持续的出院后干预措施。阿根廷七个一级儿科创伤中心的随机对照试验。年龄小于19岁的患者因诊断为重度、中度或复杂性轻度TBI而入住研究医院之一，并活着出院。患者被随机分配到干预组或标准治疗组。干预组的每个家庭都有一名经过专门培训的社区资源协调员（CRC）。我们假设，接受干预的重度、中度和复杂性轻度TBI儿童在出院后6个月的功能结局明显优于接受标准治疗的儿童。我们进一步假设，患者结局与家庭功能指标之间存在直接相关性。主要结局指标是在损伤后6个月测量的复合指标。共有308例患者纳入研究; 61%为男性。44%的患者患有复杂的轻度TBI，18%为中度，38%为重度。65%的患者为8岁或以下，超过70%的患者在没有救护车帮助的情况下被送往医院。两组之间的主要结局指标无显著差异。主要结局指标与PedsQL家庭影响模块评分之间存在统计学显著相关性（ρ= 0.57; p < 0.0001）。结果更好的儿童与受伤后6个月功能更好的家庭生活在一起。虽然没有证明干预的显着效果，但这项研究代表了拉丁美洲首次进行的记录TBI儿科患者从医院运输到医院护理到出院后的完整治疗过程的研究。
To develop, in partnership with families of children with traumatic brain injury (TBI), a post-discharge intervention that is effective, simple and sustainable. Randomized Controlled Trial Seven Level 1 Pediatric Trauma Centers in Argentina. Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild TBI, and were discharged alive. Patients were randomly assigned to either the Intervention or Standard Care group. A specially trained Community Resource Coordinator (CRC) was assigned to each family in the Intervention group. We hypothesized that children with severe, moderate, and complicated mild TBI who received the intervention would have significantly better functional outcomes at 6-months post-discharge than those who received standard care. We further hypothesized there would be a direct correlation between patient outcome and measures of family function. The primary outcome measure was a composite measured at 6-months post-injury. There were 308 patients included in the study; 61% male. Forty-four percent sustained a complicated mild TBI, 18% moderate, and 38% severe. Sixty-five percent of the patients were 8 years old or younger, and over 70% were transported to the hospital without ambulance assistance. There was no significant difference between groups on the primary outcome measure. There was a statistically significant correlation between the primary outcome measure and scores on the Family Impact Module of the PedsQL (ρ= 0.57; p < 0.0001). Children with better outcomes lived with families reporting better function at 6-months post-injury. While no significant effect of the intervention was demonstrated, this study represents the first conducted in Latin America that documents the complete course of treatment for pediatric patients with TBI spanning hospital transport through hospital care and into the post-discharge setting.