Greenspan A I, MacKenzie E J
Health Services Research and Development Center, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD.
Pediatrics. 1994 Oct;94(4 Pt 1):425-32.
To examine the consequences of head injury and the medical, economic, and sociodemographic factors affecting functional status 1 year after injury.
A follow-up was conducted on 95 children (aged 5 to 15) 1 year after they were hospitalized for head injury. Parents were interviewed by phone concerning their child's preinjury and current health status, and the family's economic and social resources during the 1 year postinjury. Inpatient medical records were reviewed to obtain information regarding the characteristics of the injury.
We found that study children were more likely than children from the general population to have limitations in physical health, behavioral problems, and to be enrolled in a special education program. These findings were true for all levels of head injury severity, although children with severe head injuries (Abbreviated Injury Scale 5) were more likely to demonstrate these functional limitations than were children with less severe injuries (Abbreviated Injury Scale 2, 3, 4). After controlling for head injury severity, we found that the poorer outcomes were associated with poverty, preinjury chronic health problems, and lower extremity injuries.
The large proportion of children who demonstrated functional limitations underscores the importance of evaluating all children hospitalized with head injuries for functional limitations and providing rehabilitation and social services when needed.
研究头部损伤的后果以及伤后1年影响功能状态的医学、经济和社会人口学因素。
对95名5至15岁因头部损伤住院的儿童进行伤后1年的随访。通过电话采访家长，了解其孩子伤前和当前的健康状况，以及伤后1年家庭的经济和社会资源。查阅住院病历以获取有关损伤特征的信息。
我们发现，与普通儿童相比，研究中的儿童在身体健康、行为问题方面更有可能存在局限，并且更有可能参加特殊教育项目。所有头部损伤严重程度的儿童均是如此，不过重度头部损伤儿童（简明损伤定级标准为5级）比轻度损伤儿童（简明损伤定级标准为2、3、4级）更有可能出现这些功能局限。在对头部损伤严重程度进行控制后，我们发现较差的预后与贫困、伤前慢性健康问题以及下肢损伤有关。
很大比例的儿童存在功能局限，这凸显了对所有因头部损伤住院的儿童进行功能局限评估以及在需要时提供康复和社会服务的重要性。
