ABSTRACT

Understanding the long-term medical and developmental outcomes for children who survive abusive head trauma (AHT) is important to ensure necessary supports and services are available. This study examined the retrospective global and specific medical and developmental outcomes of 55 children with AHT who were treated at The Children’s Hospital at Westmead. Global outcomes were assessed using the Kings Outcome Scale of Childhood Head Injury (KOSCHI). Five years post-injury, one child had died and two had made a complete recovery. Forty-five children (81.8%) had a moderate or severe disability, an increase from 64.5% at acute discharge. At follow-up, the main impairments were behavioral problems (53%), vision impairment (44%), fine motor difficulties (26%), gross motor problems (26%), communication problems (24%) and 16% had seizures. A Spearman’s Rank correlation revealed that only 41% of variance in KOSCHI scores five years post-injury could be accounted for KOSCHI scores at the time of acute discharge (rs(55) = 0.638, p < .001), and many children’s presentation was worse at follow-up. Therefore, all children presenting with AHT need long term follow up regardless of early indications of good recovery.

摘要

了解存活于虐待性头部创伤（AHT）的儿童的长期医学和发育结局对于确保获得必要的支持和服务很重要。这项研究回顾了在Westmead儿童医院接受治疗的55名AHT儿童的回顾性全球和特定医学及发育结局。使用Kings儿童头部损伤结果量表（KOSCHI）评估整体预后。受伤五年后，一名儿童死亡，两名儿童完全康复。45名儿童（81.8％）患有中度或重度残疾，比急性出院时的64.5％有所增加。随访时，主要障碍是行为问题（53％），视力障碍（44％），精细运动障碍（26％），运动障碍（26％），交流障碍（24％）和癫痫发作16％ 。p <.001），并且许多儿童的随访表现较差。因此，所有出现AHT的儿童都需要长期随访，无论早期迹象表明恢复良好。