Murdoch Childrens Research Institute, Melbourne, Australia.
J Neurotrauma. 2010 May;27(5):863-70. doi: 10.1089/neu.2009.1169.
Adult outcome from childhood brain injury is largely unknown, and health professionals have minimal evidence available to inform families about their child's long-term prognosis. This study aimed to investigate long-term outcomes in this group, focusing on quality of life (QOL) and the injury, developmental, and environmental factors that influence this domain, using a retrospective and cross-sectional design. The sample was ascertained via medical record audit at the Royal Children's Hospital, Melbourne, Australia, and included 130 adult survivors of child traumatic brain injury (TBI) (84 men). Participants were 18-42 years at evaluation (mean = 23.2, SD = 3.3) and completed questionnaires regarding QOL and educational, employment, and psychological status. Analysis of variance, chi-square, and regression were employed to assess group differences and predictors of outcome. While most adult survivors of childhood TBI rated their QOL as intact, 17% of the sample reported poor QOL. Poor QOL was more likely with low levels of perceived independence, severe TBI, younger age at injury, failure to complete high school, and psychological problems. In conclusion, QOL in adult survivors of childhood TBI is better than expected and closely associated with both injury and noninjury factors, most consistently with the individual's perception of their level of independence.
儿童期脑损伤的成人结局在很大程度上是未知的，而且健康专业人员几乎没有可用的证据来告知家庭关于其孩子的长期预后。本研究旨在通过回顾性和横断面设计，调查这一群体的长期结局，重点是生活质量（QOL）以及影响这一领域的损伤、发育和环境因素。该样本是通过在澳大利亚墨尔本皇家儿童医院的病历审核确定的，包括 130 名儿童创伤性脑损伤（TBI）的成年幸存者（84 名男性）。参与者在评估时为 18-42 岁（平均=23.2，SD=3.3），并完成了关于生活质量以及教育、就业和心理状况的问卷。方差分析、卡方检验和回归用于评估组间差异和结局的预测因素。虽然大多数儿童期 TBI 的成年幸存者认为他们的 QOL 完整，但有 17%的样本报告 QOL 较差。感知独立性低、TBI 严重、受伤时年龄较小、未能完成高中学业和心理问题更有可能导致 QOL 较差。总之，儿童期 TBI 成年幸存者的 QOL 好于预期，与损伤和非损伤因素密切相关，最一致的是个体对其独立性水平的感知。
