Pediatric Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO.
Pediatr Crit Care Med. 2018 Nov;19(11):1046-1053. doi: 10.1097/PCC.0000000000001710.
To determine the association between the Functional Status Scale and Pediatric Functional Independence Measure scores during the rehabilitation stay in children who survive traumatic brain injury.
Secondary analysis of a prospective observational cohort study.
Tertiary care children's hospital with a level 1 trauma center and inpatient rehabilitation service.
Sixty-five children less than 18 years old admitted to an ICU with acute traumatic brain injury and subsequently transferred to the inpatient rehabilitation service.
Not applicable.
Functional Status Scale and Pediatric Functional Independence Measure at transfer to rehabilitation and Pediatric Functional Independence Measure at discharge from rehabilitation. The median age of the cohort was 7.1 years (interquartile range, 0.8-12.3 yr), and 29% were female. Nearly all of the children were healthy prior to the traumatic brain injury: six patients (9.2%) had a baseline Functional Status Scale score greater than 6. At the time of transfer to inpatient rehabilitation, total Functional Status Scale and Pediatric Functional Independence Measure scores had the expected negative correlation due to increasing disability resulting in lower scores in Pediatric Functional Independence Measure and higher scores in Functional Status Scale (r = -0.49; 95% CI, -0.62 to -0.35). Among subjects with less disability as measured by lower total Functional Status Scale scores, we found substantial variability in the total Pediatric Functional Independence Measure scores. In contrast, Pediatric Functional Independence Measure scores were consistently low among subjects with a wide range of higher total Functional Status Scale scores (more disability).
Although proprietary and more time-intensive, the Pediatric Functional Independence Measure has advantages relative to the Functional Status Scale for less severely injured patients and task-specific measurements. The Functional Status Scale may have advantages relative to the Pediatric Functional Independence Measure for more severely injured patients. Further investigations are needed to characterize changes in the Functional Status Scale during the rehabilitation stay and after discharge.
确定功能状态量表与创伤性脑损伤患儿康复期间儿科功能独立性测量评分之间的关联。
前瞻性观察队列研究的二次分析。
具有 1 级创伤中心和住院康复服务的三级护理儿童医院。
65 名年龄小于 18 岁的儿童因急性创伤性脑损伤入住 ICU，随后转入住院康复服务。
不适用。
康复转移时的功能状态量表和儿科功能独立性测量以及康复出院时的儿科功能独立性测量。队列的中位年龄为 7.1 岁（四分位距，0.8-12.3 岁），29%为女性。几乎所有的孩子在创伤性脑损伤之前都是健康的：6 名患者（9.2%）的基线功能状态量表评分大于 6。在转入住院康复时，由于残疾程度增加导致儿科功能独立性测量评分降低和功能状态量表评分升高，总功能状态量表和儿科功能独立性测量评分呈现出预期的负相关（r=-0.49；95%CI，-0.62 至-0.35）。在总功能状态量表评分较低的残疾程度较低的患者中，我们发现总儿科功能独立性测量评分存在很大的差异。相比之下，在总功能状态量表评分较高（残疾程度较高）的患者中，儿科功能独立性测量评分一直较低。需要进一步研究以描述康复期间和出院后功能状态量表的变化。
