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儿科和青少年创伤后的住院康复:结果和出院需求。

Inpatient Rehabilitation After Pediatric and Adolescent Trauma: Outcomes and Discharge Needs.

机构信息

Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.

Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana.

出版信息

J Surg Res. 2022 Sep;277:279-289. doi: 10.1016/j.jss.2022.04.013. Epub 2022 May 4.

DOI:10.1016/j.jss.2022.04.013
PMID:35525210
Abstract

INTRODUCTION

Traumatic injury is the leading cause of pediatric mortality and morbidity in the United States. Pediatric trauma survivors requiring inpatient rehabilitation (IPR) require coordinated, multispecialty follow-up. Knowledge of the nature and level of disability is necessary for planning this continued care that is specific to the needs of pediatric trauma patients. This study aims to describe the outcomes of pediatric and adolescent trauma patients using measures of functional progression.

MATERIALS AND METHODS

A retrospective review of trauma patients aged ≤18 y admitted to IPR between January 2018 and December 2020 at the only certified pediatric rehabilitation center in the region was performed.

RESULTS

Ninety five children and adolescents were admitted to IPR after traumatic injury with diagnoses of multitrauma (MT, N = 18), traumatic brain injury (TBI, N = 59), and spinal cord injury (SCI, N = 18). School aged children returned to school at high rates for all injury types (MT: 86.7%, TBI: 97.4%, SCI: 93.8%, P = ns). All groups had similar hospital and rehabilitation length of stay, and most patients required a durable medical equipment at discharge (79%). Using pediatric functional independence measure scoring progression from admission to discharge from IPR, SCI patients made significant improvement in bladder function and the least improvement in stair function. Patients sustaining a TBI made significant improvement in memory and comprehension tasks.

CONCLUSIONS

Pediatric and adolescent trauma patients admitted to IPR had a positive progression during their therapy but required variable ongoing care depending on the mechanism of injury. Excellent rates of returning to school were seen across the three injury types.

摘要

简介

在美国,创伤是导致儿童死亡和发病的主要原因。需要住院康复(IPR)的儿科创伤幸存者需要多学科的协调后续治疗。了解残疾的性质和程度对于规划这种特定于儿科创伤患者需求的持续护理是必要的。本研究旨在使用功能进展的衡量标准来描述儿科和青少年创伤患者的结果。

材料和方法

对 2018 年 1 月至 2020 年 12 月期间在该地区唯一一家认证的儿科康复中心接受 IPR 的≤18 岁创伤患者进行回顾性审查。

结果

95 名儿童和青少年因多部位创伤(MT,N=18)、创伤性脑损伤(TBI,N=59)和脊髓损伤(SCI,N=18)接受 IPR。所有损伤类型的学龄儿童都以高比例返回学校(MT:86.7%,TBI:97.4%,SCI:93.8%,P=ns)。所有组的住院和康复时间相似,大多数患者在出院时需要耐用医疗设备(79%)。使用儿科功能独立性测量评分从入院到 IPR 出院的进展,SCI 患者在膀胱功能方面有显著改善,而在楼梯功能方面改善最小。患有 TBI 的患者在记忆和理解任务方面有显著改善。

结论

接受 IPR 的儿科和青少年创伤患者在治疗过程中取得了积极的进展,但根据损伤机制需要不同的持续护理。三种损伤类型的学生返回学校的比例都很高。

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