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小儿严重创伤性和非创伤性脑损伤15年后的长期职业结局

Long-Term Vocational Outcome at 15 Years from Severe Traumatic and Non-Traumatic Brain Injury in Pediatric Age.

作者信息

Strazzer Sandra, Pastore Valentina, Frigerio Susanna, Colombo Katia, Galbiati Sara, Locatelli Federica, Galbiati Susanna

机构信息

Acquired Brain Injury Unit, Scientific Institute IRCCS E. Medea, 22040 Bosisio Parini, Italy.

出版信息

Brain Sci. 2023 Jun 28;13(7):1000. doi: 10.3390/brainsci13071000.

Abstract

BACKGROUND

Recent studies suggest that acquired brain injury with impaired consciousness in infancy is related to more severe and persistent effects and may have a cumulative effect on ongoing development. In this work, we aim to describe vocational outcome in a group of patients at 15 years from a severe brain lesion they suffered in developmental age.

METHODS

This study included a total of 147 patients aged 1.5 to 14 years with acquired brain lesion. Clinical and functional details ("Glasgow Outcome Scale", "Functional Independent Measure" and Intelligence Quotient) were collected at the time of their first hospitalization and vocational outcome was determined after 15 years.

RESULTS

94 patients (63.9%) presented with traumatic brain injury, while 53 patients (36.1%) presented with a brain lesion of other origin. Traumatic patients had a higher probability of being partly or fully productive than non-traumatic ones: 75.5% of traumatic subjects were working-taking into account limitations due to the traumatic event-versus 62.3% of non-traumatic ones. A relationship between some clinical variables and the vocational outcome was found.

CONCLUSIONS

Rehabilitation should adequately emphasize "vocational rehabilitation" because a significant proportion of people experiencing a disorder of consciousness in childhood may show good social integration in adult age.

摘要

背景

近期研究表明,婴儿期获得性脑损伤伴意识障碍会产生更严重和持久的影响,并且可能对其持续发育产生累积效应。在本研究中,我们旨在描述一组患者在发育年龄时遭受严重脑损伤后15年的职业结局。

方法

本研究共纳入147例年龄在1.5至14岁之间的获得性脑损伤患者。在他们首次住院时收集临床和功能细节(“格拉斯哥预后量表”、“功能独立性测量”和智商),并在15年后确定职业结局。

结果

94例患者(63.9%)为创伤性脑损伤,而53例患者(36.1%)为其他原因导致的脑损伤。创伤性脑损伤患者比非创伤性脑损伤患者有更高的部分或完全就业概率:考虑到创伤事件导致的限制,75.5%的创伤性脑损伤患者在工作,而非创伤性脑损伤患者的这一比例为62.3%。研究发现一些临床变量与职业结局之间存在关联。

结论

康复治疗应充分强调“职业康复”,因为相当一部分童年期经历意识障碍的人在成年后可能表现出良好的社会融合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4331/10376968/b7cd2bbc54d7/brainsci-13-01000-g001.jpg

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