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入院时的功能独立性对儿童创伤性和非创伤性脑损伤早期康复的影响。

The Effect of Admission Functional Independence on Early Recovery in Pediatric Traumatic and Nontraumatic Brain Injury.

机构信息

Kessler Foundation, West Orange, New Jersey (Drs Marino, Botticello, Coyne, and DeLuca); Children's Specialized Hospital, New Brunswick, New Jersey (Drs Marino, Coyne, and Dribbon); and Departments of Physical Medicine and Rehabilitation (Drs Botticello and DeLuca) and Neurology (Dr DeLuca), Rutgers University, New Jersey Medical School, Newark, New Jersey.

出版信息

J Head Trauma Rehabil. 2018 Nov/Dec;33(6):E11-E18. doi: 10.1097/HTR.0000000000000374.

Abstract

OBJECTIVE

To examine functional independence at admission as a predictor of outcomes during an initial inpatient hospitalization for a pediatric brain injury.

PARTICIPANTS

A total of 531 pediatric inpatients with traumatic (n = 298) or nontraumatic (n = 233) brain injuries.

DESIGN

Retrospective analysis of data extracted from the Uniform Data System for Medical Rehabilitation.

MAIN MEASURE

The Functional Independence Measure for Children, a measure of self-care, mobility, and cognitive independence.

RESULTS

Logistic regression analyses indicated that children with traumatic brain injury showed greater odds of making large functional gains in comparison with children with nontraumatic brain injury. For both groups, children entering rehabilitation with a moderate level of functional independence had the highest probability of making large gains. Children with a nontraumatic brain injury entering treatment with a high level of functioning made greater gains than those entering with low functioning. The opposite trend emerged for children with traumatic injuries.

CONCLUSIONS

Level of functioning at admission may be a useful predictor of progress during an inpatient stay for youth with brain injuries. Children with nontraumatic brain injury entering treatment with low functioning are expected to make slower progress during hospitalization.

摘要

目的

探讨入院时的功能独立性是否可预测儿科脑损伤患者首次住院期间的预后。

参与者

共纳入 531 例患有创伤性(n=298 例)或非创伤性(n=233 例)脑损伤的儿科住院患者。

设计

对来自医学康复统一数据系统的数据进行回顾性分析。

主要测量指标

儿童功能独立性测量表,用于评估自理、移动和认知独立性。

结果

logistic 回归分析表明,与非创伤性脑损伤患儿相比,创伤性脑损伤患儿有更大的可能性获得较大的功能改善。对于两组患儿,入院时功能独立性处于中等水平的患儿最有可能获得较大的改善。与功能水平较低的患儿相比,功能水平较高的非创伤性脑损伤患儿在治疗过程中取得的进步更大。而对于创伤性脑损伤患儿,则出现了相反的趋势。

结论

入院时的功能水平可能是预测脑损伤青少年住院期间进展的有用指标。入院时功能水平较低的非创伤性脑损伤患儿在住院期间的进展预计会较慢。

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