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General paediatrics

https://doi.org/10.1136/adc.88.suppl_1.A66

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    G195. EARLY COGNITIVE AND PSYCHOLOGICAL OUTCOME FOLLOWING ADMISSION TO HOSPITAL FOR TRAUMATIC BRAIN INJURY (TBI) IN CHILDREN

    H. Miller, A.L. Curran, R. McCarter, I.K. Pople, P.M. Sharples and the Kids Head Injury Study Group.

    Introduction: Traumatic brain injury (TBI) is a major cause of admission to hospital in childhood. More than 90% of children will have sustained a mild head injury. It is recognised that severe TBI often results in cognitive and psychological sequelae, but there is controversy about the effects of mild TBI.

    Aims: To define cognitive and psychological outcomes at one month of children admitted to hospital with severe/moderate or mild TBI and compare them with normal non-injured controls.

    Methods: Prospective cohort study. TBI was classed by Glasgow Coma Score (GCS) as severe (GCS 3–8), moderate (GCS 9–12) or mild (GCS 13–15). Cognition was assessed by the Wechsler Intelligence Scales for Children (WISC)-111, Children’s Memory Scales (CMS), Test of Everyday Attention in Children (TEA-ch) and the Tower of London (TOL) test of executive function. Psychological response was assessed using the Birleson Depression Scale (BDS), Child Behaviour Checklist (CBCL) and Impact of Events Scale (IES).

    Results: 35 TBI subjects (15 severe/moderate; 20 mild) and 26 controls were recruited. There was no significant difference in age between TBI (mean 8.7 yrs; SEM 0.86) and control subjects (mean 9.3 yrs; SEM 0.97) (p=0.62). Children with severe/moderate TBI scored significantly lower than controls on Performance IQ (p=0.018), Verbal IQ (p=0.034), CMS (p=0.005) and the TEAch (p<0.001), but there was no significant difference in the scores obtained from mild TBI subjects compared with controls. Both severe/moderate and mild TBI children had significantly higher scores on the BDS and CBCL than controls (p=0.002; p=0.004), severe/moderate TBI subjects scoring significantly higher than mild TBI children on the BDS (p=0.03) but not the CBCL (p>0.05). 9/31 (29%) TBI children who completed the IES scored ⩾ 17, indicating clinically significant acute stress disorder. There …

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