Long-term health condition in major pediatric trauma: a pilot study

J Pediatr Surg. 2009 Aug;44(8):1591-600. doi: 10.1016/j.jpedsurg.2009.02.054.


Purpose: Major trauma is the leading cause of death in children of developed countries. However, little is known about its long-term health consequences in survivors. Our aim was to describe the health condition in children at long-term after major trauma.

Methods: Prospective cohort study of severely injured children (Injury Severity Score > or =16, age <16) admitted to a Dutch level I trauma center in 1999 to 2000 (N = 40). About 7 years after trauma (median, 7.3; range, 6.3-8.2 years), survivors' health condition was assessed with the following: guides to the evaluation of permanent impairment of the American Medical Association (AMA-guides), Glasgow Outcome Scales (GOS/GOSE), Vineland Adaptive Behavior Scales (VABS), Child Behavior Checklist (CBCL), and Strengths and Difficulties Questionnaire (SDQ).

Results: Of 40 children, 28 were followed up. Most (n = 16; 57%) had no impairments (AMA guides); minor to severe impairments were found in 12 of the respondents. About 80% (n = 22) had good recovery (GOS 5 and GOSE 7/8); the remaining had moderately disability (GOS 4 or GOSE 5/6). The mean scores on the VABS and the frequency of behavioral problems on the CBCL (24%) and the SDQ (20%) were comparable to healthy peers.

Conclusions: This long-term follow-up study after major trauma revealed that most children had a health condition comparable to healthy peers; about 40% of the respondents was physically impaired or restricted in daily activities. Our experiences with different measures may be helpful to apply age-appropriate outcome measures for the clinical follow-up of children after major trauma and to design future longitudinal studies.

MeSH terms

  • Adolescent
  • Child
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Humans
  • Injury Severity Score
  • Longitudinal Studies
  • Male
  • Netherlands / epidemiology
  • Outcome Assessment, Health Care
  • Pilot Projects
  • Prospective Studies
  • Quality of Life
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / physiopathology*
  • Wounds and Injuries / rehabilitation