Abstract
Objective: To evaluate the utility of time to follow commands (TFC) in predicting functional outcome after pediatric traumatic brain injury (TBI), as assessed by an outcome measure sensitive to the range of outcomes observed after pediatric TBI, the Glasgow Outcome Scale-Extended, Pediatric Revision (GOS-E Peds).
Setting: Pediatric inpatient rehabilitation hospital and associated multidisciplinary brain injury follow-up clinic.
Participants: Sixty-seven children with moderate-to-severe TBI (mean age at injury = 10.9 years; range, 3-18 years).
Design: Outcomes were scored retrospectively on the basis of documentation from an outpatient follow-up evaluation 1 to 2 years postinjury (days from injury to follow-up: mean = 518, SD = 137). Correlations between measures of severity and functional outcome were examined. Hierarchical logistic and linear regression analyses were performed to examine predictors of outcome.
Main Measures: Earliest documented Glasgow Coma Scale (GCS), TFC, posttraumatic amnesia (PTA), total duration of impaired consciousness (TFC + PTA), and GOS-E Peds.
Results: For the logistic regression, TFC and TFC + PTA were significant predictors of outcome above and beyond GCS. For the linear analysis, PTA was also a significant predictor of functional outcome above and beyond GCS and TFC. The overall models were very comparable, with R2 values ranging from 0.31 to 0.36 for prediction of GOS-E Peds scores.
Conclusion: Above and beyond the influence of GCS, TFC, PTA, and TFC + PTA are important predictors of later outcome after TBI.