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儿童严重创伤性脑损伤后 7 年的自我和父母报告疲劳:前瞻性纵向儿童严重创伤研究的结果。

Self- and Parent-Reported Fatigue 7 Years After Severe Childhood Traumatic Brain Injury: Results of the Traumatisme Grave de l'Enfant Prospective Longitudinal Study.

机构信息

Université Paris-Saclay, Université Paris-SUD, UVSQ, CESP, INSERM, Paris, France (Drs Câmara-Costa and Dellatolas); Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France (Drs Câmara-Costa, Dellatolas, and Chevignard and Ms Francillette); Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France (Ms Opatowski and Dr Watier); Rehabilitation Department for Children with Acquired Neurological Injury, and Outreach team for Children and Adolescents With Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France (Drs Toure, Brugel, Laurent-Vannier, and Chevignard); Paediatric Anesthesiology Department, Hôpital Necker Enfants Malades, Paris, France (Dr Meyer); Faculté de Médecine René Descartes Paris 5, Paris, France (Dr Meyer); and Groupe de Recherche Clinique Handicap Cognitif et Réadaptation (HanCRe), Sorbonne Université, Paris, France (Dr Chevignard).

出版信息

J Head Trauma Rehabil. 2020 Mar/Apr;35(2):104-116. doi: 10.1097/HTR.0000000000000502.

Abstract

OBJECTIVE

To investigate presence of and factors associated with self- and parent-reported fatigue 7 years after severe childhood traumatic brain injury (TBI) in the prospective longitudinal study TGE (Traumatisme Grave de l'Enfant-severe childhood trauma).

METHODS

Self-reports and/or parent reports on the Multidimensional Fatigue Scale were collected for 38 participants (aged 7-22 years) 7 years after severe childhood TBI, and 33 controls matched for age, gender, and parental educational level. The data collected included sociodemographic characteristics, age at injury and injury severity scores, overall disability (Glasgow Outcome Scale Extended), intellectual outcome (Wechsler scales), and questionnaires assessing executive functions, health-related quality of life, behavior, and participation.

RESULTS

Fatigue levels were significantly worse in the TBI than in the control group, especially for cognitive fatigue. Correlations of reported fatigue with age at injury, gender, TBI severity, and intellectual ability were moderate and often not significant. Fatigue was significantly associated with overall level of disability (Glasgow Outcome Scale Extended) and with all questionnaires completed by the same informant.

CONCLUSION

High levels of fatigue were reported by 30% to 50% of patients 7 years after a severe childhood TBI. Reported fatigue explained more than 60% of the variance of reported health-related quality of life by the same informant (patient or parent).

摘要

目的

在前瞻性纵向研究 TGE(儿童严重创伤)中,调查 7 年后严重儿童创伤性脑损伤(TBI)后自我报告和/或父母报告的疲劳情况及其相关因素。

方法

在严重儿童 TBI 后 7 年,对 38 名参与者(年龄为 7-22 岁)和 33 名年龄、性别和父母教育程度相匹配的对照组进行多维疲劳量表的自我报告和/或父母报告。收集的数据包括社会人口统计学特征、损伤年龄和损伤严重程度评分、总体残疾(格拉斯哥结局量表扩展)、智力结局(韦氏量表)以及评估执行功能、健康相关生活质量、行为和参与度的问卷。

结果

与对照组相比,TBI 组的疲劳水平明显更差,尤其是认知疲劳。报告的疲劳与损伤年龄、性别、TBI 严重程度和智力能力的相关性中等,且通常不显著。疲劳与整体残疾水平(格拉斯哥结局量表扩展)以及同一信息提供者完成的所有问卷显著相关。

结论

30%至 50%的严重儿童 TBI 后 7 年的患者报告了高水平的疲劳。同一信息提供者(患者或家长)报告的疲劳解释了 60%以上的报告健康相关生活质量的变异性。

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