TY  - JOUR
PY  - 2020//
TI  - Functional outcome after severe childhood traumatic brain injury: results of the TGE prospective longitudinal study
JO  - Annals of physical and rehabilitation medicine
A1  - Neumane, Sara
A1  - Câmara-Costa, Hugo
A1  - Francillette, Leila
A1  - Araujo, Mélanie
A1  - Toure, Hanna
A1  - Brugel, Dominique
A1  - Laurent-Vannier, Anne
A1  - Ewing-Cobbs, Linda
A1  - Meyer, Philippe
A1  - Dellatolas, Georges
A1  - Watier, Laurence
A1  - Chevignard, Mathilde
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Childhood severe traumatic brain injury (TBI) is a leading cause of long-lasting acquired disability, but little is known about functional outcome. <br><br>OBJECTIVE: We aimed to 1) study clinical recovery and functional outcome over 24 months after severe childhood TBI, 2) identify early sociodemographic and severity factors influencing outcome, and 3) examine the clinical utility of the Pediatric Injury Functional Outcome Scale (PIFOS) to assess functional outcome. <br><br>METHODS: Children (0-15 years) consecutively admitted in a trauma centre after accidental severe TBI over 3 years were included in a prospective longitudinal study (Traumatisme Grave de l'Enfant cohort). We measured clinical/neurological recovery, functional status (Pediatric Injury Functional Outcome Scale, [PIFOS]), overall disability (pediatric Glasgow Outcome Scale [GOS-Peds]) as well as intellectual ability (Wechsler scales) and educational outcome (mainstream school vs special education) of survivors at 1, 3, 12 and 24 months post-injury. <br><br>RESULTS: For 45 children (aged 3 to 15 years at injury), functional impairments were severe within the first 3 months. Despite the initial rapid clinical recovery and significant improvement over the first year, substantial alterations persisted for most children at 12 months post-TBI, with no significant improvement up to 2 years. Up to 80% of children still had moderate or severe overall disability (GOS-Peds) at 24 months. The severity of functional impairments (PIFOS) at 12 and 24 months was mostly related to socio-emotional, cognitive and physical impairments, and was significantly correlated with clinical/neurological deficits and cognitive (intellectual, executive) and behavioural disorders. Initial TBI severity was the main prognostic factor associated with functional status over the first 2 years post-injury. <br><br>CONCLUSIONS: Our results confirm the significant impact of severe childhood TBI on short- and medium-term functional outcomes and overall disability. All patients should benefit from systematic follow-up. The PIFOS appeared to be an accurate and reliable tool to assess functional impairment evolution and clinically meaningful outcomes over the first 2 years post-injury.<br><br>Copyright © 2020 Elsevier Masson SAS. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1877-0657
UR  - http://dx.doi.org/10.1016/j.rehab.2020.01.008
ID  - ref1
ER  -