Hawley, Carol, Ward, Anthony B., Magnay, Andrew R. and Long, Julie (2004) Outcomes following childhood head injury : a population study. Journal of Neurology Neurosurgery and Psychiatry , 75 (5). pp. 737-742. doi:10.1136/jnnp.2003.020651 ISSN 0022-3050.

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Abstract

Objectives: To identify outcomes following head injury (HI) amongst a population of children admitted to one hospital centre and compare outcomes between different severity groups.
Methods:A postal follow-up of children admitted with HI to one NHS Trust, between 1992-1998, was carried out. Children were aged 5-15 years at injury (mean 9.8), followed-up at a mean of 2.2 years post-injury. Parents of 526 injured children (419 mild, 58 moderate, 49 severe) and 45 controls completed questionnaires. Outcomes were assessed using the King’s Outcome Scale for Childhood Head Injury (KOSCHI).
Results:Frequent behavioural, emotional, memory and attentional problems were reported by one third of the severe group, one quarter of the moderate, and 10-18% of the mild. Personality change since HI was reported for 148 children (28%) (21% mild HI, 46% moderate, 69% severe). There was a significant relationship between injury severity and KOSCHI outcomes. Following the HI, 252(48%) had moderate disability (43% mild HI, 64% moderate, 69% severe), 270(51%) made a good recovery (57% mild HI, 36% moderate, 22% severe). There was a significant association between social deprivation and poor outcome (p=0.002). Only 30%(158) of children received hospital follow-up after the HI. All children with severe disability received appropriate follow-up, but 64% of children with moderate disability received none. No evidence was found to suggest a threshold of injury severity below which the risk of late sequelae could be safely discounted.
Conclusions:Children admitted with mild HI may be at risk of poor outcomes, but often do not receive routine hospital follow-up. A postal questionnaire combined with the KOSCHI to assess outcomes after HI may be used to identify children who would benefit from clinical assessment. Further research is needed to identify factors which place children with mild HI at risk of late morbidity.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine R Medicine > RJ Pediatrics
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Children -- Wounds and injuries, Head -- Wounds and injuries, Outcome assessment (Medical care), Brain damaged children, Brain -- Wounds and injuries
Journal or Publication Title:	Journal of Neurology Neurosurgery and Psychiatry
Publisher:	BMJ
ISSN:	0022-3050
Official Date:	2004
Dates:	Date Event 2004 Published
Volume:	75
Number:	5
Page Range:	pp. 737-742
DOI:	10.1136/jnnp.2003.020651
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)

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