Multidisciplinary rehabilitation and follow-up for children hospitalized with traumatic brain injury.

Abstract

PurposeMost children hospitalized with traumatic brain injury (TBI) acquire new impairments that impact function and health-related quality of life. However, there is a lack of standardized, multidisciplinary, longitudinal rehabilitative services for children with TBI.MethodsThis single center, retrospective study evaluated rehabilitative services during acute hospitalization and identified the frequency of unmet needs, defined as new or untreated impairments at the first acquired brain injury (ABI) clinic visit.ResultsAnalysis was conducted for 148 children hospitalized for TBI (mild/complicated mild [51%], moderate [14%], or severe [35%]) and evaluated at ABI clinic (median of 63 [43-122] days post-hospitalization). Eighty-two (55%) patients had at least one unmet need at initial clinic assessment. Executive function impairments were found in children with mild/complicated mild TBI (32%), despite only 5% of them receiving speech therapy (ST) prior to the clinic. Only 13% of children with severe TBI received outpatient ST at first clinic visit despite 26% and 20% identified as having executive function and communication impairments. Earlier consultation of physical therapy, occupational therapy, ST, and physiatry was associated with discharge home versus inpatient rehabilitation, all p < .05.ConclusionThis study demonstrates the importance of timely inpatient acute hospital rehabilitative care coordinated with longitudinal, multidisciplinary follow-up for children after TBI.