Background: Longitudinal fatigue data in children suffering from traumatic brain injury (TBI) are lacking.
Objectives: To examine the effects of time postinjury (6-12 months) and injury severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12 months postinjury against published control data.
Setting: Three tertiary children's hospitals across Australia (n = 1) and Canada (n = 2).
Participants: Parents (n = 109) of children (mean [M] = 9.9 years at injury; range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n = 69) or moderate/severe (n = 37) TBI.
Design: Longitudinal prospective study.
Measures: Primary: Pediatric Quality of Life Multidimensional Fatigue Scale (total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic and children data were collected at recruitment.
Results: Mixed-models analysis demonstrated nonsignificant effects of time (6 vs 12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue worsened over time. Moderate/severe TBI was associated with worse fatigue 12 months postinjury (general, P = .03; cognitive, P = .02). Across all severities, fatigue 12 months postinjury was significantly worse compared with control data (total fatigue, P < .001; all domains, all Ps < .025).
Conclusion: Fatigue remains significant at 12 months since injury, particularly for those with moderate/severe TBI.
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http://dx.doi.org/10.1097/HTR.0000000000000330 | DOI Listing |
J Head Trauma Rehabil
September 2024
Author Affiliations: Department of Psychology, University of Calgary, Calgary, Alberta (Ms Luszawski and Dr Yeates); Alberta Children's Hospital Research Institute, Calgary, Alberta (Ms Luszawski and Dr Yeates); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta (Ms Luszawski and Dr Yeates); Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio (Ms Minich, Dr Bacevice, and Dr Bangert); Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Ms Minich and Dr Bacevice); Department of Psychology and Neuroscience, Brigham Young University, Provo, Utah and Departments of Neurology and Psychiatry, University of Utah, Salt Lake City, Utah (Dr Bigler); Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Dr Taylor); Department of Pediatrics, The Ohio State University, Columbus, Ohio (Drs Taylor, Cohen, and Zumberge); Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio (Dr Cohen); Department of Radiology, University Hospitals of Cleveland, Cleveland, Ohio (Dr Bangert); Radiology, Nationwide Children's Hospital, Columbus, Ohio (Dr Zumberge); Educational and Counselling Psychology, University of British Columbia, Vancouver, British Columbia (Dr Tomfohr-Madsen); Neurosciences Program, Alberta Children's Hospital, Calgary, Alberta (Dr Brooks); and Departments of Pediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Calgary, Alberta (Dr Brooks).
Objective: Sleep disturbance (SD) is common after pediatric mild traumatic brain injury (mTBI) and may predict increased postconcussive symptoms (PCS) and prolonged recovery. Our objective was to investigate the relation of SD with PCS in children with mTBI and those with orthopedic injury (OI).
Setting: Emergency departments (EDs) at 2 children's hospitals in the Midwestern United States.
Child Neuropsychol
January 2025
Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Persisting symptoms after concussion (PSaC) affect up to 30% of children, adolescents, and young adults beyond 1 month post-injury, posing challenges in clinical care. This retrospective study examined 54 patients referred for neuropsychological evaluation due to PSaC, exploring factors contributing to symptom persistence. Results showed that 75.
View Article and Find Full Text PDFBackground: Floating knee injuries, involving simultaneous fractures of the femur and tibia in the same limb, present complex challenges in management. These injuries are often associated with high-energy trauma and carry significant morbidity.
Aims And Objectives: This study aims to evaluate the management strategies, challenges, and clinico-radiological outcomes of floating knee injuries in Jharkhand.
J Trauma Acute Care Surg
January 2025
From the Department of Surgery (P.L.J., M.R.H., C.L.M., J.R.M., J.D.K., J.L.J.), University of Michigan Medical School; Center for Healthcare Outcomes and Policy (P.L.J., M.R.H., C.L.M., B.W.O., J.W.S.) and Department of Orthopedic Surgery (B.W.O.), University of Michigan Medical School; Department of Surgery (W.J.C.), Trinity Health Ann Arbor Hospital, Ann Arbor; Department of Surgery (B.D.M.), University of Michigan Health-Sparrow, Lansing; Department of Surgery (A.N.K.), Trinity Health Oakland Campus, Pontiac, Michigan; and Department of Surgery (J.W.S.), University of Washington, Harborview Medical Center, Seattle, Washington.
Background: As increased attention is placed on optimizing long-term outcomes of trauma patients by addressing mental health, little is known regarding the interplay of pre- and postinjury mental health on long-term financial and functional outcomes.
Methods: Patients from 19 Level 1 and 2 trauma centers took part in serial surveys 1 to 24 months postdischarge. Preinjury mental health diagnoses were identified using trauma registry data and postinjury mental health symptoms from survey data.
Brain Res
January 2025
Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. Electronic address:
Traumatic brain injury (TBI) can lead to chronic neuroinflammation, and neurodegeneration associated with long-term cognitive deficits. Following TBI, the acute neuroinflammatory response involves microglial activation and the release of proinflammatory cytokines and chemokines which induce the recruitment of peripheral immune cells such as monocytes and ultimately T cells. Persistent innate and adaptive immune cells response can lead to chronic neurodegeneration and functional deficits.
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