Modelling early recovery patterns after paediatric traumatic brain injury

Archives of Disease in Childhood
Rob J ForsythJames R Christensen

Abstract

To describe the range of early recovery patterns seen in children admitted for inpatient rehabilitation after traumatic brain injury and to build simple predictive models of expected recovery. 103 consecutive paediatric admissions to a neurological rehabilitation facility after closed head injury. Children's recoveries were defined by repeated scores on the WeeFIM (a validated paediatric measure of functional independence) assembled into recovery trajectories. Non-linear mixed effects modelling was used to define 'typical' recoveries and to identify useful simple predictor variables. WeeFIM recovery curves showed a characteristic sigmoidal form with an initial slow phase followed by a mid-phase of fastest improvement and a late plateau. Final WeeFIM scores ranged from 18 to 125 (median 105, IQR 87-117). The time taken to reach 50% final WeeFIM score ranged from 5 to 145 days (median 27, IQR 17-46). Both final WeeFIM and time to reach 50% final WeeFIM correlated with time to follow commands (TFC), defined as the post-injury day on which a child was first observed to follow two simple commands in a 24 h period. Simple models predicting outcome trajectory can be built incorporating early rate-of recovery indices (such as TFC) as p...Continue Reading

Citations

Jun 20, 2012·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Rob Forsyth, Fenella Kirkham
Aug 7, 2021·Journal of Personalized Medicine·Erika MolteniSandra Strazzer

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

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