Pediatric Polytrauma

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Abstract
Objective To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods All pediatric polytrauma patients (Injury Severity Score of >or=to 16, <or=to 15 years of age) who were treated at a Level I trauma center between 1985 and 1989 and who were 18 years or older at follow-up (1996) were included. Short-term outcomes were quantified using the Glasgow Outcome Scale. The Functional Independence Measure, the RAND-36, and questions on social outcome were used to assess long-term outcomes. Measurements and Main Results Fifty-nine of 74 patients survived (80%). At 1 year after injury, 22% were disabled, mainly due to severe brain injuries, and 32% had changed school. After 9 years of follow-up, the degree of physical disablement was low (12%). Cognitive impairments were found in 42% of the patients. Only 10% were in receipt of disablement allowances; 76% were employed or attended school. The quality of life enjoyed by the patients (RAND-36) did not differ from that enjoyed by a healthy reference population. The Glasgow Outcome Scale (from 6 weeks onward) was a good predictor of long-term disablement. Conclusions Although the short-term impact of injuries is extensive, the long-term outcomes are satisfactory. Severe injuries sustained during childhood do not lead to a diminished quality of life during adulthood.

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