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J Pediatr Intensive Care 2023; 12(01): 055-062
DOI: 10.1055/s-0042-1758475
Original Article

Determinants of Quality of Life after Pediatric Traumatic Brain Injury

Nazan Ulgen Tekerek 
1   Division of Pediatric Intensive Care, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Oguz Dursun 
1   Division of Pediatric Intensive Care, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Selen Karalok 
2   Division of Pediatric Neurology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Alper Koker 
1   Division of Pediatric Intensive Care, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Ozgur Duman 
2   Division of Pediatric Neurology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Senay Haspolat 
2   Division of Pediatric Neurology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Abstract

Introduction Pediatric traumatic brain injury (TBI) is a significant cause of death and long-term disability. There is a paucity of data on quality of life in survivors of pediatric TBI. The aim of this study is to determine the factors affecting the quality of life after TBI in children.

Methods Consecutively admitted 104 of 156 patients to the pediatric intensive care unit (PICU) with TBI between 1 month and 18 years were included in the study. Demographics were obtained from electronic records. Injury severity and mortality scores were calculated. The Pediatric Quality of Life Inventory (PedsQL) scale and Glasgow Outcome Scale (GOS) score were evaluated by interview with patient or the caregiving parents. The Rotterdam computed tomography (CT) score was calculated from the radiology images taken within the first 24 hours after admission to the emergency service.

Results Severe TBI, multiple trauma, intracranial hemorrhage from multiple sites, convulsions, high intracranial pressure, emergency operation on admission, and hypotension on admission were associated with low PedsQL values according to results of univariate analysis (p < 0.05). There was a negative correlation between PedsQL and GOS, mechanical ventilation duration, PICU length of stay (LOS), and hospital LOS. In the linear regression model made by considering the univariate analysis results, it was shown that Rotterdam CT score and PICU LOS are independent variables that determine low PedsQL score. PedsQL scores were lower in children ≥ 8 years of age and in those evaluated within the first year after discharge (p = 0.003).

Conclusion In pediatric TBI, Rotterdam CT score and PICU LOS were found as independent variables determining PedsQL score after discharge.

Keywords

children - trauma - outcome - Rotterdam score

Ethical Approval

The study was approved by the local ethics committee (no. KAEK-645).


Consent to Participate

Informed consent was obtained from the participants or their parents.


Supplementary Material



Publication History

Received: 17 May 2022

Accepted: 16 September 2022

Article published online:
11 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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