Risk Factors for Residual Medical Needs after Pediatric Trauma Injury

项目摘要 每年约有30万儿童因非致命性创伤住院。创伤科有 有可能导致儿童生活质量终身下降，并使他们面临更大的风险， 残疾和早期死亡率。创伤幸存者可能会经历身体和精神健康的持久缺陷， 导致继发性疾病，包括疼痛，肌肉骨骼功能障碍，认知障碍， 心理社会问题和睡眠障碍这些情况会进一步导致参与度下降 在体育活动，不良的学校表现，和物质使用。到目前为止，关于这一点的知识还很少。 儿童创伤幸存者的医疗保健需求，这可能与成人人口不同。 有一个关键的需要，以建立一个证据基础，为以后的指导方针，为医生改善遵循- 儿童受伤后的护理。 这项研究的长期目标是确定儿童创伤人群未满足的健康需求， 设计改善功能结果和减少残疾的医疗保健干预措施。改进这些 长期结果需要更好的随访数据采集： 测量和评估急性期后护理服务。改善长期成果的一个主要障碍 儿童创伤性损伤是缺乏可靠的，纵向数据的儿科患者住院后 放电该提案的目的是确定以下两年的医疗保健利用模式： 并评估父母对受伤儿童的健康需求。这项探索性研究的目的是 1）确定严重损伤后儿童医疗保健利用的长期模式，2）确定是否 受伤儿童在出院后接受建议的后续护理，3）描述父母的 创伤后急性期后护理的现实障碍，以及4）确定父母是否报告未满足 儿童在紧急恢复阶段之后的保健需要。 这项研究意义重大，因为拟议的研究为改善随访护理奠定了基础， 这不仅有助于为受伤的儿童取得更好的结果，而且还可以防止未来的健康问题， 成年人了我们预计，这些发现将提供证据，以支持急性和后， 急性服务纳入受伤病人的“无缝护理系统”，并将提供必要的数据， 制定以患者为中心的儿童创伤后急性期后护理指南。

PROJECT SUMMARY Approximately 300,000 children are hospitalized for nonfatal, traumatic injuries each year. Trauma has the potential to lead to a life-long decrease in the quality of a child's life and place them at increased risk for disability and early mortality. Trauma survivors can experience lasting deficits in physical and mental health, leading to secondary conditions including pain, musculoskeletal dysfunction, cognitive impairment, psychosocial difficulties, and sleep disturbances. These conditions can further lead to decreased participation in physical activities, poor school performance, and substance use. To date, little knowledge exists about the health care needs of pediatric survivors of traumatic injury, which are likely distinct from the adult population. There is a critical need to develop an evidence base to inform later guidelines for physicians to improve follow- up care after childhood injury. The long-term goal of this research is to determine unmet health needs of the pediatric trauma population and to design healthcare interventions that improve functional outcomes and reduce disability. Improving these long-term outcomes requires better follow-up data acquisition: both acquiring unbiased pre-injury baseline measurements and assessing post-acute care services. A major obstacle to improving long-term outcomes of children with traumatic injury is the lack of reliable, longitudinal data on pediatric patients after hospital discharge. The objective of this proposal is to identify patterns of healthcare utilization for two years following injury and to assess parent-perceived health needs of injured children. The aims of this exploratory study are to 1) identify long-term patterns of healthcare utilization in children after a critical injury, 2) determine whether injured children are receiving recommended follow-up care after leaving the hospital, 3) characterize parents' real-world barriers to post-acute care after traumatic injury, and 4) determine whether parents report unmet health needs of children beyond the acute phase of recovery. This research is significant because the proposed studies lay the foundation for improved follow-up care that will not only help achieve better outcomes for injured children, but may also prevent future health problems as adults. We anticipate that these findings will provide evidence to support the integration of acute and post- acute services into a “seamless system of care” for injured patients and will provide data essential to developing patient-centered guidelines for post-acute care after childhood trauma.