Contributors: Service de Rééducation des pathologies neurologiques acquises de l'enfant Hôpitaux de Saint Maurice; Hôpitaux de Saint Maurice (HNSM); Sorbonne Université - Faculté de Médecine (SU FM); Sorbonne Université (SU); Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Laboratoire d'Imagerie Biomédicale Paris (LIB); Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS); Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP); Université Toulouse III - Paul Sabatier (UT3); Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM); Service Pharmacologie Clinique CHU Toulouse; Pôle Santé publique et médecine publique CHU Toulouse; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); The University of Texas Medical School at Houston; The University of Texas Health Science Center at Houston (UTHealth); Hôpital Necker - Enfants Malades AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Université Paris Descartes - Faculté de Médecine (UPD5 Médecine); Université Paris Descartes - Paris 5 (UPD5); Groupe de recherche clinique Handicap Moteur et Cognitif et Réadaptation (GRC 24 - HaMCRe ); Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses (B2PHI); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur Paris (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM); In depth analyses and manuscript preparation were funded thanks to a co-funding by the French Ministry of Health's general direction of health and direction of research, studies, assessment and statistics, by the national fund for health insurance of salaried workers, the national fund for health insurance of independent workers, by the national fund for solidarity and autonomy and by the national institute for prevention and education for health, in the call for research projects launched by the IReSP in 2011, and by two grant(s) awarded to Hugo Câmara-Costa: one grant from the French Speaking Society of Research in Children with Disabilities (SFERHE, www.sferhe.org) and one joint grant from the French Traumatic Brain Injury Society (France Traumatisme Crânien – FTC) and the French Speaking Society of Physical Medicine and Rehabilitation (SOFMER, www.sofmer.com). Thus, the "French Ministry of Health's general direction of health (Direction Générale de la Santé) and direction of research, studies, assessment and statistics" is a funding body on its own, that co-funded the study in this joint call.
نبذة مختصرة : International audience ; Background: Childhood severe traumatic brain injury (TBI) is a leading cause of long-lasting acquired disability, but little is known about functional outcome.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.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.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.Conclusions: Our results confirm the significant impact of severe childhood TBI on short- and medium-term functional outcomes and overall disability. All patients should ...
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