• Frederick P Rivara, Thomas D Koepsell, Jin Wang, Nancy Temkin, Andrea Dorsch, Monica S Vavilala, Dennis Durbin, and Kenneth M Jaffe.
• Department of Pediatrics, University of Washington, Seattle, Washington, USA. fpr@uw.edu
• Pediatrics. 2011 Nov 1;128(5):e1129-38.

ObjectiveTo examine disability in children and adolescents after traumatic brain injury (TBI) across the spectrum of injury severity.MethodsThis was a prospective cohort study of children younger than 18 years treated for a TBI (n = 729) or an arm injury (n = 197) between March 1, 2007, and September 30, 2008. The main outcome measures were disability in health-related quality of life, adaptive skills, and participation in social and community activities 3, 12, and 24 months after injury compared with preinjury functioning.ResultsThe health-related quality of life for children with moderate or severe TBI was lower at all follow-up times compared with baseline, but there was some improvement during the first 2 years after injury. Three months after injury, there was a substantial decrease in the level of activities in which children with moderate and severe TBI were able to participate; these activities improved at 12 and 24 months but were still significantly impaired. Communication and self-care abilities in children with moderate and severe TBI were lower at 3 months than at baseline and did not improve by 24 months. Children who met the definition of mild TBI but had an intracranial hemorrhage had lower quality-of-life scores at 3 months.ConclusionsChildren with moderate or severe TBI and children with mild TBI who had intracranial hemorrhage had substantial long-term reduction in their quality of life, participation in activities with others, and ability to communicate and care for themselves.

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