Cole Wesley R, Gerring Joan P, Gray Robert M, Vasa Roma A, Salorio Cynthia F, Grados Marco, Christensen James R, Slomine Beth S
Kennedy Krieger Institute, Baltimore, MD 21202, USA.
Brain Inj. 2008 Nov;22(12):932-9. doi: 10.1080/02699050802454808.
The goals of this study were to explore the prevalence of aggressive behaviours after severe paediatric traumatic brain injury (TBI) and identify predictors of aggressive behaviours 1 year post-injury.
A cohort of 97 children aged 4-19 years at time of severe TBI (GCS 3-8) were prospectively followed for 1 year. Pre-injury psychiatric status was obtained retrospectively at enrolment and post-injury behavioural and functional concerns were assessed at 1 year. Aggression was measured with a modified version of the Overt Aggression Scale (OAS).
Results revealed aggressive behaviour increased from pre-injury to post-injury. Pre-injury factors including aggression, attention problems and anxiety were associated with increased post-injury aggressive behaviour. Children with greater disability after injury were also at increased risk for aggressive behaviours.
Aggression is a prevalent symptom after paediatric TBI and can significantly impede rehabilitation. Awareness of these predictors can aid in early identification of children at risk in order to help appropriately design rehabilitation programmes.
本研究的目的是探讨小儿重度创伤性脑损伤（TBI）后攻击行为的发生率，并确定伤后1年攻击行为的预测因素。
对97名重度TBI（格拉斯哥昏迷评分3 - 8分）时年龄在4 - 19岁的儿童进行为期1年的前瞻性随访。在入组时回顾性获取伤前精神状态，并在1年时评估伤后行为和功能问题。使用改良版的公开攻击量表（OAS）测量攻击行为。
结果显示攻击行为从伤前到伤后有所增加。伤前因素包括攻击行为、注意力问题和焦虑与伤后攻击行为增加有关。伤后残疾程度较重的儿童出现攻击行为的风险也增加。
攻击行为是小儿TBI后的常见症状，可显著阻碍康复。了解这些预测因素有助于早期识别有风险的儿童，以便帮助合理设计康复计划。
