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• W4313218431 abstract "Introduction: Children who suffer abusive head trauma (AHT) are at high risk of morbidity and mortality. We hypothesized that children after AHT would have a higher incidence of new impairment compared to children after accidental traumatic brain injury (aTBI) at discharge, 1 y, and 5 y post-discharge. Methods: Children < 3y old admitted with TBI to the Pediatric Intensive Care Unit (PICU) at a Level 1 Trauma Center between 2014-2019 were included. Patient and injury characteristics, TBI mechanism (abuse vs. accident) and Functional Status Scale (FSS) scores (pre-TBI, hospital discharge, and 1 and 5 y post-discharge) were abstracted from the electronic health record. New impairment was defined as change in FSS > 2 from baseline. Patients who died were assigned the highest FSS score. Multivariate logistic regression was performed to determine variables associated with new impairment at hospital discharge, 1 y, and 5 y post-discharge. Results: Three-hundred and sixteen patients (160 AHT, 156 aTBI) were included in this study of which 13 children with AHT and 3 children with aTBI died. The mean age for each group was 7 mo (2, 25) for aTBI and 4 mo (2, 9) for AHT. Children with AHT had worse admission Injury Severity Scores (ISS) compared to aTBI (10 [9, 17] vs. 17 [10, 26], p<.001). Frequency of new impairment in AHT vs. aTBI patients were as follows: discharge (38/160 [24%] vs. 16/156 [10%], p<.05), 1 y (22/144 [15%] vs. 11/139 [12%], p=0.08), and 5 y (17/108 [16%] vs. 3/96 [3%], p<.05). All FSS domain scores were worse for AHT vs. aTBI patients at discharge while sensory and communication scores remained worse in AHT patients at 1 and 5 y. On multivariate analysis controlling for admission ISS, age, sex, and race, AHT was associated with new impairment at hospital discharge (odds ratio 3.4, 95% confidence interval [1.5, 8.1]) and 5 y (4.6 [1.4, 21.6]), p<.05, but not at 1 y (1.8, [0.8, 4.4]), p=.20. Conclusions: AHT patients had worse injury severity on admission and more longitudinal functional impairment than children with aTBI. Children with TBI, especially AHT, require long-term care coordination and support for recovery." @default.
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• W4313218431 date "2022-12-15" @default.
• W4313218431 modified "2023-10-16" @default.
• W4313218431 title "14: LONGITUDINAL FUNCTIONAL OUTCOMES IN ABUSIVE HEAD TRAUMA VERSUS ACCIDENTAL TRAUMATIC BRAIN INJURY" @default.
• W4313218431 doi "https://doi.org/10.1097/01.ccm.0000905932.82571.b8" @default.
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