Effect of treatment on outcome after TBI in children and adolescents

治疗对儿童和青少年 TBI 后结局的影响

• 批准号: 8464500
• 负责人: FREDERICK P. RIVARA
• 金额: $ 55万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2017-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8464500
• 关键词: Effect; treatment; outcome; after; TBI

DESCRIPTION (provided by applicant): Studies over the last two decades have described the epidemiology of TBI in children and adolescents, outlined the natural history of recovery, and determined the functional outcome following injury. Important questions remain about the effect of treatment during the acute, short-term, and longer-term phases of care on the functional, psychosocial, and disability outcomes after TBI. In this project, Harborview Medical Center, Texas Children's Hospital, Nationwide Children's Hospital, and the Children's Hospital of Philadelphia propose a multicenter study of complicated mild, moderate, and severe TBI occurring to individual's ages 7-18 years to address these aims: Aim 1. Characterize complicated mild, moderate and severe TBI with respect to age, cause, type of injury, accompanying signs and symptoms, type and severity of medical and surgical co-morbidities, and pre-existing conditions, functional status at admission and discharge from the acute care hospital; and examine the association between specific characteristics of TBI and educational, vocational, behavioral, and social outcomes 6, 12, 24 and 36 months after injury. Aim 2. Determine the treatment received during the initial hospitalization for TBI, and during inpatient and outpatient rehabilitation and therapy, and the relationship of treatment to demographic and injury factors. Aim 3. Determine the association of treatment received during the acute inpatient and rehabilitation phases of care with the educational, vocational, behavioral, and social functional outcomes 6, 12, 24 and 36 months after injury, including the association with attainment of educational and vocation milestones at different developmental stages. This study will address many of the unanswered questions on pediatric TBI. It is innovative in many ways. It is a multi-centered study bringing together leading expertise in the United States on pediatric TBI. It will employ the newly developed Common Data Elements for characterizing injuries and the newly developed quality of care indicators for characterizing their inpatient rehabilitation care. The study will utilize the new PROMIS outcome measures and collect data in a longitudinal fashion from both caregivers and patients using web- based technology. By applying novel statistical approaches designed to assess causal effects in observational designs, it will provide critical information on the effects of treatment at different stages of cae on functional outcomes after TBI. The study team represents a uniquely interdisciplinary group of very experienced investigators who are capable of carrying out a rigorous study to provide information to inform future research, care and policy. PUBLIC HEALTH RELEVANCE: Project Narrative This study will address many of these unanswered questions surrounding pediatric traumatic brain injury (TBI), including determining the effect of treatment during the acute, short-term, and longer-term phases of care on the functional, psychosocial, and disability outcomes after TBI occurring to children and adolescents. It will study TBI of different severity and follow children over the 3 years after injury.

描述（由申请人提供）：在过去的二十年中，研究描述了儿童和青少年中TBI的流行病学，概述了恢复的自然历史，并确定了受伤后的功能结果。关于治疗在TBI后急性，短期和长期护理阶段对功能，社会心理和残疾结果的急性，短期和长期阶段治疗的影响仍然存在的重要问题。在这个项目中，Harbourview医疗中心，得克萨斯州儿童医院，全国儿童医院以及费城儿童医院提出了一项针对7-18岁人口的复杂，中度和严重的TBI的多中心研究，以解决这些目标：AIM 1。急诊医院入院时的合并症和先前存在的条件，功能状况；并检查受伤后6、12、24和36个月的TBI特定特征与教育，职业，行为和社会成果之间的关联。 AIM 2。确定在初次住院期间接受TBI的治疗方法，以及住院和门诊康复和治疗期间，以及治疗与人口统计学和伤害因素的关系。 AIM 3。确定在受伤后的教育，职业，行为和社会功能结果与教育，职业，行为和社会功能结果的急性住院和康复阶段所接受的治疗之间的关联，包括在不同发育阶段与获得教育和职业里程碑的关系。这项研究将解决有关小儿TBI的许多未解决问题。这在许多方面都是创新的。这是一项以多为中心的研究，将在美国的小儿TBI汇集了领先的专业知识。它将采用新开发的常见数据元素来表征伤害和新开发的护理指标，以表征其住院康复护理。该研究将利用新的Promis结果指标，并使用基于Web的技术从护理人员和患者那里以纵向方式收集数据。通过应用旨在评估观察性设计因果关系的新型统计方法，它将提供有关CAE不同阶段治疗对TBI功能结果的影响的关键信息。研究团队代表了一个独特的跨学科小组，由经验丰富的研究人员组成，他们能够进行严格的研究以提供信息，以告知未来的研究，护理和政策。 公共卫生相关性：项目叙事本研究将解决有关小儿创伤性脑损伤（TBI）的许多未解决的问题，包括确定护理急性，短期和长期护理对功能，心理社会和残疾人的急性，短期和长期阶段的影响。它将研究不同严重程度的TBI，并在受伤后的三年内关注儿童。