While injury is still the leading cause of death for children older than 1 year of age, we have made great strides in reducing the number of children killed from trauma, particularly in motor vehicle crashes. This is something the injury prevention community should be proud of and continue to work toward. However, given that the overall survival rate for children with moderate to severe trauma is greater than 95 percent, it is equally as important to understand the burden of disabling injuries in children.
In December, we published a study in Pediatrics analyzing the injury-related physical disabilities of children before and after admission to inpatient rehabilitation. Most of the nearly 14,000 children 7- to 18-years-old from 2002 to 2011 showed an improvement in their physical capabilities at discharge from treatment. However, children with spinal cord injuries had longer lengths of stay and more disability at discharge, and even the many children with improved functionality over their stay still required assistance for day-to-day tasks.
Severe traumatic brain injuries and spinal cord injuries are life-changing, and often permanent. It is important to understand a child’s severity of disability at the end of inpatient rehabilitation, as this is when a child begins the process of re-integrating into their family, community, schools, and society. By understanding risk factors for disability, we can focus our efforts along the prevention spectrum from pre-injury (through education and behavior changes), during the injury (through engineering and product design), and post-injury (through enhancing trauma care and rehabilitory care).
This study is the first in a line of research the Center will be conducting on functional disability following pediatric trauma. The next phase will assess the cognitive functioning for this same group of children, which will provide a more complete picture of the scale of their injuries and long-term care needs.
The team at CIRP was inspired by one young woman’s brave fight at CHOP's Children’s Seashore House to recover from serious brain injuries sustained in a prom night crash in 2010. Her story is available here.