Fatigue Following Traumatic Brain Injury in Children and Adolescents: A Longitudinal Follow-Up 6 to 12 Months After Injury.

J Head Trauma Rehabil

Murdoch Children's Research Institute, Melbourne, Victoria, Australia (Drs Crichton, Anderson, and Babl, Mr Oakley, and Mss Greenham and Delzoppo); Victorian Peadiatric Rehabilitation Service, Monash Children's, Melbourne, Victoria, Australia (Dr Crichton); Department of Psychology (Dr Anderson) and School of Psychological Sciences (Dr Crichton and Ms Greenham), University of Melbourne, Melbourne, Victoria, Australia; Department of Peadiatrics, University of Melbourne, Melbourne, Victoria, Australia (Dr Babl and Mr Oakley); Royal Children's Hospital (RCH), Melbourne, Victoria, Australia (Mr Oakley, Dr Babl, and Ms Delzoppo); Department of Psychology, University of Montreal, Montreal, Quebec, Canada (Dr Beauchamp); Research Center, Ste-Justine Hospital (HSJ), Montreal, Quebec, Canada (Dr Beauchamp) Neuroscience and Mental Health Research Program (Drs Hutchison and Guerguerian), The Hospital for Sick Children (HSK), Toronto, Ontario, Canada (Drs Hutchison, Guerguerian, and Boutis); and University of Toronto, Toronto, Ontario, Canada (Drs Hutchison and Boutis).

Published: August 2019

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.0000000000000330DOI Listing

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