Halldorsson Jonas G, Arnkelsson Gudmundur B, Tomasson Kristinn, Flekkoy Kjell M, Magnadottir Hulda Bra, Arnarson Eirikur Orn
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Brain Inj. 2013;27(10):1106-18. doi: 10.3109/02699052.2013.765599. Epub 2013 Jul 25.
To assess long-term effects of early traumatic brain injury (TBI) on mental health, cognition, behaviour and adjustment and to identify prognostic factors.
A 1-year nationwide cohort of all 0-19 year old Icelandic children and adolescents diagnosed with TBI in 1992-1993 (n = 550) received a questionnaire with clinical outcome scales and questions on TBI and socio-economic status (SES) by mail ∼16 years post-injury. A control group (n = 1232), newly selected from the National Registry, received the same questionnaire. Non-respondents answered a shorter version by telephone. Overall participation was 67%.
Medically confirmed and self-reported TBI was reflected in worse outcome. Force of impact, number and severity of TBIs predicted poorer results. Parental SES and demographic factors had limited effects. Not reporting early, medically confirmed TBI did not exclude cognitive sequelae. In self-reported disability, absence of evaluation for compensation was not linked to outcome.
Clinical outcome was consistent with late complaints attributed to early TBI. TBI-related variables had greater prognostic value than other factors. Self-reporting of TBI sustained very early in life needs supplementary information from parents and medical records. More consistency in compensation evaluations following paediatric TBI is indicated.
评估早期创伤性脑损伤（TBI）对心理健康、认知、行为和适应能力的长期影响，并确定预后因素。
对1992 - 1993年确诊为TBI的所有冰岛0至19岁儿童和青少年进行为期1年的全国性队列研究（n = 550），在受伤约16年后通过邮件向他们发送一份包含临床结局量表以及关于TBI和社会经济地位（SES）问题的问卷。从国家登记处新选取一个对照组（n = 1232），向其发放相同问卷。未回复者通过电话回答简短版本问卷。总体参与率为67%。
医学确诊和自我报告的TBI反映在较差的结局中。撞击力、TBI的次数和严重程度预示着更差的结果。父母的SES和人口统计学因素影响有限。未早期报告医学确诊的TBI并不排除认知后遗症。在自我报告的残疾情况中，未进行赔偿评估与结局无关。
临床结局与早期TBI导致的后期主诉一致。与TBI相关的变量比其他因素具有更大的预后价值。生命早期持续存在的TBI自我报告需要来自父母和病历的补充信息。表明儿科TBI后赔偿评估需要更多一致性。
