Functional outcomes following injury in pediatric patients without traumatic brain injury
Background: Pediatric trauma patients often have disability after successful resuscitation for hemorrhage. Clinical characteristics related to dependency on living following injury were elucidated among pediatric patients without traumatic brain injury. Methods: This retrospective cohort study used...
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Elsevier
2025-01-01
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| Series: | Journal of Pediatric Surgery Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949711624000686 |
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| author | Ryo Yamamoto Lillian Liao Keitaro Yajima Akira Endo Kazuma Yamakawa Junichi Sasaki |
| author_facet | Ryo Yamamoto Lillian Liao Keitaro Yajima Akira Endo Kazuma Yamakawa Junichi Sasaki |
| author_sort | Ryo Yamamoto |
| collection | DOAJ |
| description | Background: Pediatric trauma patients often have disability after successful resuscitation for hemorrhage. Clinical characteristics related to dependency on living following injury were elucidated among pediatric patients without traumatic brain injury. Methods: This retrospective cohort study used the 2019–2021 Japan Trauma Data Bank and included pediatric patients aged ≤16 years without head injury (Abbreviated Injury Scale [AIS] ≥ 2). The unfavorable function was defined as dependency in daily life at discharge (Glasgow Outcome Scale ≤ 3), and predictors for unfavorable functional outcomes were examined using a generalized estimating equations (GEE) model, including age, sex, physical disability before injury, injury mechanism, transportation time, prehospital procedures, vital signs on arrival, surgery in each body region, transfusion, AIS in each region, and institutions. Furthermore, these factors were analyzed separately in toddler/preschool (≤5 years), school age (6–11 years), and adolescence (12–16 years). Results: Among 1,412 patients eligible for the study, 137 had an unfavorable physical function at discharge. The GEE model revealed that female sex, physical disability before injury, prehospital transfusion, lower Glasgow Coma Score (GCS) score on arrival, neck surgery, and higher AIS in the neck and extremity/pelvis were independently associated with unfavorable function at discharge. In age-specific analyses, physical disability before injury strongly predicted worse functional outcomes in toddlers/preschoolers, whereas higher AIS in the chest and lower systolic blood pressure on arrival were additional predictors of dependent living among adolescents. Conclusions: Severe neck/extremity/pelvis injury and lower GCS on arrival are associated with unfavorable functional outcomes in patients with pediatric trauma. |
| format | Article |
| id | doaj-art-5b4430f082934f87989a5e593a5f6a8c |
| institution | Kabale University |
| issn | 2949-7116 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Open |
| spelling | doaj-art-5b4430f082934f87989a5e593a5f6a8c2025-01-22T05:44:36ZengElsevierJournal of Pediatric Surgery Open2949-71162025-01-019100183Functional outcomes following injury in pediatric patients without traumatic brain injuryRyo Yamamoto0Lillian Liao1Keitaro Yajima2Akira Endo3Kazuma Yamakawa4Junichi Sasaki5Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan; Department of Surgery, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA; Correspondence author at: Trauma Service/Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku Tokyo, 160-8582, Japan.Department of Surgery, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USADepartment of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, JapanDepartment of Acute Critical Care Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, JapanDepartment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki Osaka, 569-8686, JapanDepartment of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, JapanBackground: Pediatric trauma patients often have disability after successful resuscitation for hemorrhage. Clinical characteristics related to dependency on living following injury were elucidated among pediatric patients without traumatic brain injury. Methods: This retrospective cohort study used the 2019–2021 Japan Trauma Data Bank and included pediatric patients aged ≤16 years without head injury (Abbreviated Injury Scale [AIS] ≥ 2). The unfavorable function was defined as dependency in daily life at discharge (Glasgow Outcome Scale ≤ 3), and predictors for unfavorable functional outcomes were examined using a generalized estimating equations (GEE) model, including age, sex, physical disability before injury, injury mechanism, transportation time, prehospital procedures, vital signs on arrival, surgery in each body region, transfusion, AIS in each region, and institutions. Furthermore, these factors were analyzed separately in toddler/preschool (≤5 years), school age (6–11 years), and adolescence (12–16 years). Results: Among 1,412 patients eligible for the study, 137 had an unfavorable physical function at discharge. The GEE model revealed that female sex, physical disability before injury, prehospital transfusion, lower Glasgow Coma Score (GCS) score on arrival, neck surgery, and higher AIS in the neck and extremity/pelvis were independently associated with unfavorable function at discharge. In age-specific analyses, physical disability before injury strongly predicted worse functional outcomes in toddlers/preschoolers, whereas higher AIS in the chest and lower systolic blood pressure on arrival were additional predictors of dependent living among adolescents. Conclusions: Severe neck/extremity/pelvis injury and lower GCS on arrival are associated with unfavorable functional outcomes in patients with pediatric trauma.http://www.sciencedirect.com/science/article/pii/S2949711624000686Prognosis studylevel II |
| spellingShingle | Ryo Yamamoto Lillian Liao Keitaro Yajima Akira Endo Kazuma Yamakawa Junichi Sasaki Functional outcomes following injury in pediatric patients without traumatic brain injury Journal of Pediatric Surgery Open Prognosis study level II |
| title | Functional outcomes following injury in pediatric patients without traumatic brain injury |
| title_full | Functional outcomes following injury in pediatric patients without traumatic brain injury |
| title_fullStr | Functional outcomes following injury in pediatric patients without traumatic brain injury |
| title_full_unstemmed | Functional outcomes following injury in pediatric patients without traumatic brain injury |
| title_short | Functional outcomes following injury in pediatric patients without traumatic brain injury |
| title_sort | functional outcomes following injury in pediatric patients without traumatic brain injury |
| topic | Prognosis study level II |
| url | http://www.sciencedirect.com/science/article/pii/S2949711624000686 |
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