Johnson Abigail R, DeMatt Ellen, Salorio Cynthia F
Department of Pediatric Rehabilitation, Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD 21205, USA.
Dev Disabil Res Rev. 2009;15(2):124-32. doi: 10.1002/ddrr.63.
Acquired brain injury (ABI) in children and adolescents can result from multiple causes, including trauma, central nervous system infections, noninfectious disorders (epilepsy, hypoxia/ischemia, genetic/metabolic disorders), tumors, and vascular abnormalities. Prediction of outcomes is important, to target interventions, allocate resources, provide education to family or caregivers, and begin appropriate planning for the future. Researchers have identified several factors associated with better or worse outcomes after ABI, including variables related to the injury itself, postinjury factors related to intervention or trajectory of recovery, and preinjury or demographic factors. When examining the scientific literature, it is important to identify how "outcome" is defined, as the predictors may change depending on the outcome studied. In addition, key variables may be specific to the etiology of injury. Therefore, predictors of outcome cannot be generalized across the various etiologies of ABI, and this review will discuss predictors within the context of multiple etiologies of ABI. This article reviews the current literature on predicting outcomes after pediatric ABI, and areas in need of further research are discussed.
儿童和青少年获得性脑损伤(ABI)可由多种原因引起,包括创伤、中枢神经系统感染、非感染性疾病(癫痫、缺氧/缺血、遗传/代谢疾病)、肿瘤和血管异常。对预后进行预测很重要,有助于确定干预措施、分配资源、为家庭或照顾者提供教育,并为未来开始适当的规划。研究人员已经确定了几个与ABI后更好或更差预后相关的因素,包括与损伤本身相关的变量、与干预或恢复轨迹相关的损伤后因素,以及损伤前或人口统计学因素。在查阅科学文献时,重要的是要确定“预后”是如何定义的,因为预测因素可能会根据所研究的预后而变化。此外,关键变量可能因损伤的病因而异。因此,不能将预后的预测因素推广到ABI的各种病因中,本综述将在ABI多种病因的背景下讨论预测因素。本文综述了目前关于预测儿童ABI预后的文献,并讨论了需要进一步研究的领域。