Fay G C, Jaffe K M, Polissar N L, Liao S, Rivara J B, Martin K M
Department of Rehabilitation Medicine, University of Washington, Seattle.
Arch Phys Med Rehabil. 1994 Jul;75(7):733-41.
This cohort study examined the neurobehavioral, academic, and "real world" consequences of mild, moderate, and severe traumatic brain injury in children at 3 years following the resolution of posttraumatic amnesia. Seventy-two children, aged 6 to 15 years at time of injury, were individually matched with controls on the basis of age, gender, school grade, and the classroom teacher's assessment of premorbid academic achievement and behavior. Both groups were assessed using the same standardized neuropsychological test battery and parent and teacher report measures as were used initially and at 1-year follow-up covering 10 cognitive, behavioral, and functional domains. The performance of both moderately and severely injured children was worse than their controls on 40 out of 53 variables. The association of outcome variables with injury severity was validated using school achievement tests and grades. Analyses of the impact of preinjury variables and study dropouts on outcome showed no threat to the validity of study findings. These results provide strong validation for the persisting and comprehensive nature of neuropsychological deficits in children and adolescents with moderate and severe traumatic brain injury.
这项队列研究调查了创伤后遗忘症消退3年后，儿童轻度、中度和重度创伤性脑损伤的神经行为、学业及“现实世界”后果。72名受伤时年龄在6至15岁的儿童，根据年龄、性别、年级以及任课教师对病前学业成绩和行为的评估，与对照组进行个体匹配。两组均使用相同的标准化神经心理测试组合以及家长和教师报告量表进行评估，这些量表与最初及1年随访时使用的相同，涵盖10个认知、行为和功能领域。在53个变量中，中度和重度受伤儿童在40个变量上的表现均不如对照组。使用学业成就测试和成绩验证了结果变量与损伤严重程度之间的关联。对伤前变量和研究失访对结果的影响进行分析，结果表明对研究结果的有效性没有威胁。这些结果有力地证实了中度和重度创伤性脑损伤儿童及青少年神经心理缺陷的持续性和综合性。
