Risk Factors for Residual Medical Needs after Pediatric Trauma Injury

项目总结 每年大约有300,000名儿童因非致命性和创伤性伤害而住院。精神创伤有 有可能导致儿童的生活质量终生下降，并使他们面临更高的风险 残疾和早期死亡。创伤幸存者可能会经历持久的身心健康缺陷， 导致继发性疾病，包括疼痛，肌肉骨骼功能障碍，认知障碍， 心理社交困难和睡眠障碍。这些情况可能会进一步导致参与率下降。 在体育活动中，在学校表现不佳，以及使用药物。到目前为止，人们对此知之甚少。 儿童创伤幸存者的医疗保健需求可能与成人人群不同。 迫切需要建立一个证据基础，以便为以后的医生指南提供信息，以改善对- 儿童受伤后的护理。 这项研究的长期目标是确定儿科创伤人群未得到满足的健康需求，并 设计改善功能结果和减少残疾的医疗干预措施。改善这些 长期结果需要更好的后续数据获取：两者都获得无偏见的伤害前基线 衡量和评估急性后护理服务。改善长期成果的一个主要障碍是 儿童创伤是缺乏可靠的、关于儿科患者出院后的纵向数据 出院。这项建议的目标是确定以下两年的医疗保健利用模式 评估受伤儿童的父母感知的健康需求。这项探索性研究的目的是 1)确定危重伤害后儿童医疗保健利用的长期模式，2)确定 受伤的孩子在出院后正在接受推荐的后续护理，3)父母的特征 创伤后急诊护理的现实障碍，以及4)决定父母是否报告未得到满足 儿童在急性期康复后的健康需求。 这项研究具有重要意义，因为拟议的研究为改善后续护理奠定了基础 不仅有助于为受伤的儿童取得更好的结果，还可能防止未来的健康问题，因为 成年人。我们预计，这些发现将提供证据，支持急性和后遗症的整合。 将急诊服务纳入受伤病人的“无缝护理系统”，并将提供必要数据 制定以患者为中心的儿童创伤后急性护理指南。

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.