TY - JOUR
T1 - Cause, treatment costs and 12-month functional outcomes of children with major injury in NSW, Australia
AU - Curtis, Kate
AU - Kennedy, Belinda
AU - Lam, Mary K.
AU - Mitchell, Rebecca J.
AU - Black, Deborah
AU - Burns, Brian
AU - White, Leslie
AU - Loudfoot, Allan
AU - D'Amato, Alfa
AU - Dinh, Michael
AU - Holland, Andrew J. A.
N1 - Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2020/9
Y1 - 2020/9
N2 - Background: Information about children treated in New South Wales (NSW), Australia following major injury has been limited to those treated at trauma centres using mortality as the main outcome measure, restricting assessment of the effectiveness of the Trauma System. This study sought to describe the detailed characteristics as well as functional and psychosocial health outcomes of all children suffering major injury in NSW. Methods: A longitudinal study was conducted between July 2015 and November 2017 and included children < 16 years requiring intensive care or an injury severity score (ISS) ≥ 9 treated in NSW or who died following injury. Children were identified through the three NSW Paediatric Trauma Centres (PTC), the NSW Trauma Registry, NSW Aeromedical Retrieval Registry (AirMaestro) and the National Coronial Information System (NCIS). Health-related quality of life (HRQoL) outcomes for children treated at the three PTCs were collected at baseline, 6 and 12 months using the Paediatric Quality of Life inventory (PedsQL 4.0) and EuroQol five-dimensional EQ-5D-Y. Results: There were 625 children, with a median (interquartile range) age of 7 (2–13) years and 71.7% were male. Around half were injured in major cities (51.2%). The median (IQR) injury severity score (ISS) was 10 (9–17). Twelve-month HRQoL measured by PedsQL remained below baseline for psychosocial health. Treatment costs increased with injury severity (p=<0.001) and polytrauma (p=<0.001). No survival benefit was demonstrated between PTC versus non-PTC definitive care. Injured females and children from rural / remote NSW were overrepresented in the deceased. Conclusion: Children treated in NSW following major injury have reduced quality of life and in particular, reduced emotional well-being at 12 months post-injury. Improved psychosocial care and outpatient follow-up is required to minimise the long-term emotional impact of injury on the child.
AB - Background: Information about children treated in New South Wales (NSW), Australia following major injury has been limited to those treated at trauma centres using mortality as the main outcome measure, restricting assessment of the effectiveness of the Trauma System. This study sought to describe the detailed characteristics as well as functional and psychosocial health outcomes of all children suffering major injury in NSW. Methods: A longitudinal study was conducted between July 2015 and November 2017 and included children < 16 years requiring intensive care or an injury severity score (ISS) ≥ 9 treated in NSW or who died following injury. Children were identified through the three NSW Paediatric Trauma Centres (PTC), the NSW Trauma Registry, NSW Aeromedical Retrieval Registry (AirMaestro) and the National Coronial Information System (NCIS). Health-related quality of life (HRQoL) outcomes for children treated at the three PTCs were collected at baseline, 6 and 12 months using the Paediatric Quality of Life inventory (PedsQL 4.0) and EuroQol five-dimensional EQ-5D-Y. Results: There were 625 children, with a median (interquartile range) age of 7 (2–13) years and 71.7% were male. Around half were injured in major cities (51.2%). The median (IQR) injury severity score (ISS) was 10 (9–17). Twelve-month HRQoL measured by PedsQL remained below baseline for psychosocial health. Treatment costs increased with injury severity (p=<0.001) and polytrauma (p=<0.001). No survival benefit was demonstrated between PTC versus non-PTC definitive care. Injured females and children from rural / remote NSW were overrepresented in the deceased. Conclusion: Children treated in NSW following major injury have reduced quality of life and in particular, reduced emotional well-being at 12 months post-injury. Improved psychosocial care and outpatient follow-up is required to minimise the long-term emotional impact of injury on the child.
KW - Emergency
KW - Injury
KW - Mortality
KW - Outcomes
KW - Paediatric
KW - Psychosocial
KW - Treatment costs
UR - http://www.scopus.com/inward/record.url?scp=85085307331&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/nhmrc/1092499
U2 - 10.1016/j.injury.2020.04.030
DO - 10.1016/j.injury.2020.04.030
M3 - Article
C2 - 32471685
AN - SCOPUS:85085307331
SN - 0020-1383
VL - 51
SP - 2066
EP - 2075
JO - Injury
JF - Injury
IS - 9
ER -