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非常年幼的儿童创伤性脑损伤后的长期智力功能。

Long-Term Intellectual Function After Traumatic Brain Injury in Very Young Children.

机构信息

Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia (Drs Crowe, Catroppa, Babl, Godfrey, and Anderson); School of Psychological Science, University of Melbourne, Melbourne, Victoria, Australia (Drs Crowe, Godfrey, and Anderson); and Psychology Service (Drs Crowe, Godfrey, and Anderson) and Emergency Department (Dr Babl), Royal Children's Hospital, Melbourne, Victoria, Australia.

出版信息

J Head Trauma Rehabil. 2021;36(2):E126-E133. doi: 10.1097/HTR.0000000000000626.

Abstract

OBJECTIVE

To investigate long-term intellectual function following a traumatic brain injury (TBI) in early childhood and to identify the contribution of injury and environment to outcome.

PARTICIPANTS

Fifty children younger than 3 years with a diagnosis of accidental TBI were recruited through a pediatric hospital emergency department. Children with TBI were compared with a group (n = 33) of typically developing children (TDC) matched on demographics.

DESIGN

Longitudinal, single-site, case-control study.

MEASURES

Children completed intellectual assessments (IQ) at 4.5 to 5.5 years of age (average 3.5 years after TBI) and at 7.5 to 9 years of age (average 6.5 years after TBI). Information on injury and environmental predictors of outcome was collected.

RESULTS

IQ scores for all groups were in the average range; however, children with TBI of any severity had lower scores than TDC at both time points. There was some suggestion of children with TBI achieving lower verbal IQ scores over time than TDC. IQ scores were predicted by family environment, not injury characteristics.

CONCLUSIONS

A TBI in early childhood is associated with lower IQ scores that persist several years postinjury. Socioeconomic status is an influential factor on IQ at 6.5 years post-TBI.

摘要

目的

探讨儿童早期创伤性脑损伤(TBI)后的长期智力功能,并确定损伤和环境对结果的贡献。

参与者

通过儿科医院急诊室招募了 50 名年龄在 3 岁以下、诊断为意外 TBI 的儿童。将 TBI 患儿与一组(n=33)在人口统计学上相匹配的正常发育儿童(TDC)进行比较。

设计

纵向、单站点、病例对照研究。

测量

儿童在 4.5 至 5.5 岁(TBI 后平均 3.5 年)和 7.5 至 9 岁(TBI 后平均 6.5 年)时完成智力评估(智商)。收集了关于损伤和环境预测结果的信息。

结果

所有组的智商评分均处于平均范围;然而,任何严重程度的 TBI 患儿的评分均低于 TDC 在两个时间点。有一些迹象表明,TBI 患儿的言语智商评分随时间逐渐下降,而 TDC 则没有。智商评分受家庭环境影响,而非损伤特征。

结论

儿童早期 TBI 与智商评分降低有关,且这种情况在受伤后持续数年。社会经济地位是 TBI 后 6.5 年智商的一个影响因素。

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