Residual Cognitive Disability after Completion of Inpatient Rehabilitation among Injured Children

J Pediatr, 2014 · DOI: 10.1016/j.jpeds.2013.09.022 · Published: January 1, 2014

Simple Explanation

This study looks at the cognitive abilities of children aged 7-18 after they've been through inpatient rehabilitation for traumatic injuries. The study found that children with traumatic brain injuries (TBI) had more cognitive problems when they started rehabilitation and still had more problems when they finished, compared to children with spinal cord injuries or other injuries. Understanding these differences can help families know what to expect during rehabilitation and plan for the support children will need after they leave the hospital.

Study Duration

10 years

Participants

13 798 injured children aged 7-18 years

Evidence Level

Not specified

Key Findings

1
Children with TBI had more severe cognitive disability on admission to inpatient rehabilitation compared to those with spinal cord injury or other injuries.
2
Although cognitive functioning improved for all patients during inpatient rehabilitation, children with TBI still had significant residual cognitive disability on discharge.
3
Patients with SCI had longer LOS values than those without SCI.

Research Summary

The study aimed to determine the prevalence and nature of residual cognitive disability after inpatient rehabilitation for children aged 7-18 years with traumatic injuries. The study found that children with TBI had more severe cognitive disability on admission and more residual disability on discharge compared to children with SCI or other injuries. These findings have implications for patient and family expectation setting and for resource and service planning for children with serious injury.

Practical Implications

Realistic Expectations

The study helps set realistic expectations for patients and their families regarding cognitive recovery during and after inpatient rehabilitation, particularly for those with TBI.

Resource Allocation

The findings can inform resource allocation and service planning to better meet the specific cognitive rehabilitation needs of children with TBI, SCI, and other traumatic injuries.

Targeted Interventions

The study supports the development and implementation of targeted interventions to address the residual cognitive deficits observed in children with TBI following inpatient rehabilitation.

Study Limitations

1
The database may not be completely representative of all severely injured patients discharged from acute care.
2
There were no consistently documented International Classification of Diseases, Ninth Revision E codes for injury mechanism, which precluded analyses associating outcomes with injury causation.
3
Assessment of functionality at discharge from rehabilitation may not reflect long-term function or assistive needs.

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