Factors Influencing Pediatric Recovery from Traumatic Brain Injury

Authors

  • Andrew Feldman Department of Neurology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY https://orcid.org/0000-0003-4125-8713
  • Sean Thomas Department of Physical Medicine and Rehabilitation, Temple University, Philadelphia, PA
  • Joseph C. Hess Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
  • Mechelle M. Lewis Department of Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA & Department of Pharmacology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA https://orcid.org/0000-0002-1375-689X
  • Brett Engbrecht Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
  • Beverly Shirk Department of Pediatrics, Penn State Health Milton S. Hershey Medical Center, Hershey, PA https://orcid.org/0000-0001-8501-8856
  • Harry Bramley Department of Pediatrics, Penn State Health Milton S. Hershey Medical Center, Hershey, PA

DOI:

https://doi.org/10.26209/psjm61904

Keywords:

concussion, TBI, traumatic brain injury

Abstract

Purpose: Many factors are linked to prolonged recovery from traumatic brain injury (TBI) in the pediatric population. This study investigated risk factors to aid anticipatory guidance and treatment strategies. 

Methods: A retrospective chart review was conducted utilizing 133 patients admitted to a pediatric trauma service at a Level 1 Pediatric Trauma Center. 

Results: No significant difference in recovery time was found based on acute injury severity as graded by initial Glasgow Coma Score (GCS) (GCS of 3-12 median recovery of 34 days vs GCS 13-15 median recovery of 34 days (p = 0.393)) and presence of intracranial hemorrhage (ICH) (ICH median recovery of 34 days vs no ICH median recovery of 30 days (p = 0.506)). Patients with post-concussive sleep disturbances (median recovery of 53.5 days (p = 0.002)) and comorbid mood disorders (anxiety and/or depression median recovery of 143 days (p = 0.009), ADHD median recovery of 45 days (p = 0.012) showed an increased median recovery length. The median recovery time severe of moderate initial injury (GCS of 3-12 median recovery of 34 days (p = 0.00244)) and mild initial injury (GCS 13-15 median recovery of 34 days (p<0.001)) was longer as compared to outpatient studies (17 days). 

Conclusions: This study verified that GCS and ICH upon admission are not correlated with recovery, whereas sleep disturbances and comorbid mood disorders are strong prognostic factors for prolonged recovery. A longer median recovery time, compared to outpatient studies, suggests that patients admitted to a pediatric trauma service are at risk for prolonged recovery.

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Published

2020-10-15

Issue

Vol. 1 (2020): Penn State Journal of Medicine - Fall 2020 Edition

Section

Original Article

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