Abstract
BackgroundIn high income countries, injuries account for 40 % of all child deaths, representing the leading cause of child mortality and a major source of morbidity. The need for studies across age groups, and use of health related quality of life measures that assess functional limitations in multiple health domains, with sampling at specific post-injury time points has been identified. The objective of this study was to describe the impact of childhood injury and recovery on health related quality of life (HRQoL) for the 12 months after injury.MethodsIn this prospective cohort study parents of children 0-16 years old attending British Columbia Children’s Hospital for an injury were surveyed over 12 months post-injury. Surveys assessed HRQoL at four points: baseline (pre-injury), one month, four to six months and 12 months post injury. Generalized estimating equation models identified factors associated with changes in HRQoL over time.ResultsA total of 256 baseline surveys were completed. Response rates for follow-ups at one, four and twelve months were 74 % (186), 67 % (169) and 64 % (161), respectively. The mean age of participants was 7.9 years and 30 % were admitted to the hospital. At baseline, a retrospective measure of pre-injury health, the mean HRQoL score was 90.7. Mean HRQoL ratings at one, four and 12 months post injury were 77.8, 90.3 and 91.3, respectively. Both being older and being hospitalized were associated with a steeper slope to recovery.ConclusionsAlthough injuries are prevalent, the long term impacts of most childhood injuries are limited. Regardless of injury severity, most injured children recuperated quickly, and had regained total baseline status by four month post-injury. However, although hospitalization did not appear to impact long term psychosocial recovery, at four and 12 months post injury a greater proportion of hospitalized children continued to have depressed physical HRQoL scores. Both older and hospitalized children reported greater impact to HRQoL at one month post injury, and both had a steeper slope to recovery and were on par with their peers by four month.
Highlights
In high income countries, injuries account for 40 % of all child deaths, representing the leading cause of child mortality and a major source of morbidity
The analytic sample was not statistically different than the broader population of all injured children based on sex or age, the children in our sample had higher odds of being hospitalized and lower odds of being in the lowest 2 income quintiles relative to all injured children presenting at the hospital during the study period (Table 2)
The majority of children included in this study were previously healthy with 87 % of parents indicating that their child had zero days of ill health in the four weeks preceding the injury
Summary
Injuries account for 40 % of all child deaths, representing the leading cause of child mortality and a major source of morbidity. The need for studies across age groups, and use of health related quality of life measures that assess functional limitations in multiple health domains, with sampling at specific post-injury time points has been identified. The objective of this study was to describe the impact of childhood injury and recovery on health related quality of life (HRQoL) for the 12 months after injury. Injuries account for 40 % of all child deaths in highincome countries, representing the leading cause of child mortality and a major source of morbidity [1]. Measuring health related quality of life (HRQoL) after injury facilitates quantifying the impact on multiple dimensions of health and the recovery process. Research following child injury on psychological outcomes, is currently investigating predictors and early intervention strategies, and the present study can help build towards these interventions [6,7,8]
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