Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina: A Multicenter Randomized Controlled Trial

Nancy Carney, Gustavo J. Petroni, Silvia B. Luján, Nicolás M. Ballarini, Gabriela A. Faguaga, Hugo E M du Coudray, Amy E. Huddleston, Gloria M. Baggio, Juan M. Becerra, Leonardo O. Busso, Sureyya S. Dikmen, Roberto Falcone, Mirta E. García, Osvaldo R. González Carrillo, Paula L. Medici, Marta B. Quaglino, Carina A. Randisi, Silvia S. Sáenz, Nancy R. Temkin, Elida E. Vanella

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE:: To develop, in partnership with families of children with traumatic brain injury, a postdischarge intervention that is effective, simple, and sustainable. DESIGN:: Randomized Controlled Trial. SETTING:: Seven Level 1 Pediatric Trauma Centers in Argentina. PATIENTS:: Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild traumatic brain injury and were discharged alive. INTERVENTIONS:: Patients were randomly assigned to either the intervention or standard care group. A specially trained Community Resource Coordinator was assigned to each family in the intervention group. We hypothesized that children with severe, moderate, and complicated mild traumatic brain injury who received the intervention would have significantly better functional outcomes at 6 months post discharge than those who received standard care. We further hypothesized that there would be a direct correlation between patient outcome and measures of family function. MEASUREMENTS AND MAIN RESULTS:: The primary outcome measure was a composite measured at 6 months post injury. There were 308 patients included in the study (61% men). Forty-four percent sustained a complicated mild traumatic brain injury, 18% moderate, and 38% severe. Sixty-five percent of the patients were 8 years old or younger, and over 70% were transported to the hospital without ambulance assistance. There was no significant difference between groups on the primary outcome measure. There was a statistically significant correlation between the primary outcome measure and the scores on the Family Impact Module of the Pediatric Quality of Life Inventory (ρ = 0.57; p <0.0001). Children with better outcomes lived with families reporting better function at 6 months post injury. CONCLUSIONS:: Although no significant effect of the intervention was demonstrated, this study represents the first conducted in Latin America that documents the complete course of treatment for pediatric patients with traumatic brain injury spanning hospital transport through hospital care and into the postdischarge setting.

Original languageEnglish (US)
JournalPediatric Critical Care Medicine
DOIs
StateAccepted/In press - May 27 2016

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Argentina
Brain Concussion
Randomized Controlled Trials
Pediatrics
Outcome Assessment (Health Care)
Ambulances
Latin America
Trauma Centers
Wounds and Injuries
Quality of Life
Traumatic Brain Injury
Equipment and Supplies

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Carney, N., Petroni, G. J., Luján, S. B., Ballarini, N. M., Faguaga, G. A., du Coudray, H. E. M., ... Vanella, E. E. (Accepted/In press). Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina: A Multicenter Randomized Controlled Trial. Pediatric Critical Care Medicine. https://doi.org/10.1097/PCC.0000000000000772

Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina : A Multicenter Randomized Controlled Trial. / Carney, Nancy; Petroni, Gustavo J.; Luján, Silvia B.; Ballarini, Nicolás M.; Faguaga, Gabriela A.; du Coudray, Hugo E M; Huddleston, Amy E.; Baggio, Gloria M.; Becerra, Juan M.; Busso, Leonardo O.; Dikmen, Sureyya S.; Falcone, Roberto; García, Mirta E.; González Carrillo, Osvaldo R.; Medici, Paula L.; Quaglino, Marta B.; Randisi, Carina A.; Sáenz, Silvia S.; Temkin, Nancy R.; Vanella, Elida E.

In: Pediatric Critical Care Medicine, 27.05.2016.

Research output: Contribution to journalArticle

Carney, N, Petroni, GJ, Luján, SB, Ballarini, NM, Faguaga, GA, du Coudray, HEM, Huddleston, AE, Baggio, GM, Becerra, JM, Busso, LO, Dikmen, SS, Falcone, R, García, ME, González Carrillo, OR, Medici, PL, Quaglino, MB, Randisi, CA, Sáenz, SS, Temkin, NR & Vanella, EE 2016, 'Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina: A Multicenter Randomized Controlled Trial', Pediatric Critical Care Medicine. https://doi.org/10.1097/PCC.0000000000000772
Carney, Nancy ; Petroni, Gustavo J. ; Luján, Silvia B. ; Ballarini, Nicolás M. ; Faguaga, Gabriela A. ; du Coudray, Hugo E M ; Huddleston, Amy E. ; Baggio, Gloria M. ; Becerra, Juan M. ; Busso, Leonardo O. ; Dikmen, Sureyya S. ; Falcone, Roberto ; García, Mirta E. ; González Carrillo, Osvaldo R. ; Medici, Paula L. ; Quaglino, Marta B. ; Randisi, Carina A. ; Sáenz, Silvia S. ; Temkin, Nancy R. ; Vanella, Elida E. / Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina : A Multicenter Randomized Controlled Trial. In: Pediatric Critical Care Medicine. 2016.
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abstract = "OBJECTIVE:: To develop, in partnership with families of children with traumatic brain injury, a postdischarge intervention that is effective, simple, and sustainable. DESIGN:: Randomized Controlled Trial. SETTING:: Seven Level 1 Pediatric Trauma Centers in Argentina. PATIENTS:: Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild traumatic brain injury and were discharged alive. INTERVENTIONS:: Patients were randomly assigned to either the intervention or standard care group. A specially trained Community Resource Coordinator was assigned to each family in the intervention group. We hypothesized that children with severe, moderate, and complicated mild traumatic brain injury who received the intervention would have significantly better functional outcomes at 6 months post discharge than those who received standard care. We further hypothesized that there would be a direct correlation between patient outcome and measures of family function. MEASUREMENTS AND MAIN RESULTS:: The primary outcome measure was a composite measured at 6 months post injury. There were 308 patients included in the study (61{\%} men). Forty-four percent sustained a complicated mild traumatic brain injury, 18{\%} moderate, and 38{\%} severe. Sixty-five percent of the patients were 8 years old or younger, and over 70{\%} were transported to the hospital without ambulance assistance. There was no significant difference between groups on the primary outcome measure. There was a statistically significant correlation between the primary outcome measure and the scores on the Family Impact Module of the Pediatric Quality of Life Inventory (ρ = 0.57; p <0.0001). Children with better outcomes lived with families reporting better function at 6 months post injury. CONCLUSIONS:: Although no significant effect of the intervention was demonstrated, this study represents the first conducted in Latin America that documents the complete course of treatment for pediatric patients with traumatic brain injury spanning hospital transport through hospital care and into the postdischarge setting.",
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T1 - Postdischarge Care of Pediatric Traumatic Brain Injury in Argentina

T2 - A Multicenter Randomized Controlled Trial

AU - Carney, Nancy

AU - Petroni, Gustavo J.

AU - Luján, Silvia B.

AU - Ballarini, Nicolás M.

AU - Faguaga, Gabriela A.

AU - du Coudray, Hugo E M

AU - Huddleston, Amy E.

AU - Baggio, Gloria M.

AU - Becerra, Juan M.

AU - Busso, Leonardo O.

AU - Dikmen, Sureyya S.

AU - Falcone, Roberto

AU - García, Mirta E.

AU - González Carrillo, Osvaldo R.

AU - Medici, Paula L.

AU - Quaglino, Marta B.

AU - Randisi, Carina A.

AU - Sáenz, Silvia S.

AU - Temkin, Nancy R.

AU - Vanella, Elida E.

PY - 2016/5/27

Y1 - 2016/5/27

N2 - OBJECTIVE:: To develop, in partnership with families of children with traumatic brain injury, a postdischarge intervention that is effective, simple, and sustainable. DESIGN:: Randomized Controlled Trial. SETTING:: Seven Level 1 Pediatric Trauma Centers in Argentina. PATIENTS:: Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild traumatic brain injury and were discharged alive. INTERVENTIONS:: Patients were randomly assigned to either the intervention or standard care group. A specially trained Community Resource Coordinator was assigned to each family in the intervention group. We hypothesized that children with severe, moderate, and complicated mild traumatic brain injury who received the intervention would have significantly better functional outcomes at 6 months post discharge than those who received standard care. We further hypothesized that there would be a direct correlation between patient outcome and measures of family function. MEASUREMENTS AND MAIN RESULTS:: The primary outcome measure was a composite measured at 6 months post injury. There were 308 patients included in the study (61% men). Forty-four percent sustained a complicated mild traumatic brain injury, 18% moderate, and 38% severe. Sixty-five percent of the patients were 8 years old or younger, and over 70% were transported to the hospital without ambulance assistance. There was no significant difference between groups on the primary outcome measure. There was a statistically significant correlation between the primary outcome measure and the scores on the Family Impact Module of the Pediatric Quality of Life Inventory (ρ = 0.57; p <0.0001). Children with better outcomes lived with families reporting better function at 6 months post injury. CONCLUSIONS:: Although no significant effect of the intervention was demonstrated, this study represents the first conducted in Latin America that documents the complete course of treatment for pediatric patients with traumatic brain injury spanning hospital transport through hospital care and into the postdischarge setting.

AB - OBJECTIVE:: To develop, in partnership with families of children with traumatic brain injury, a postdischarge intervention that is effective, simple, and sustainable. DESIGN:: Randomized Controlled Trial. SETTING:: Seven Level 1 Pediatric Trauma Centers in Argentina. PATIENTS:: Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild traumatic brain injury and were discharged alive. INTERVENTIONS:: Patients were randomly assigned to either the intervention or standard care group. A specially trained Community Resource Coordinator was assigned to each family in the intervention group. We hypothesized that children with severe, moderate, and complicated mild traumatic brain injury who received the intervention would have significantly better functional outcomes at 6 months post discharge than those who received standard care. We further hypothesized that there would be a direct correlation between patient outcome and measures of family function. MEASUREMENTS AND MAIN RESULTS:: The primary outcome measure was a composite measured at 6 months post injury. There were 308 patients included in the study (61% men). Forty-four percent sustained a complicated mild traumatic brain injury, 18% moderate, and 38% severe. Sixty-five percent of the patients were 8 years old or younger, and over 70% were transported to the hospital without ambulance assistance. There was no significant difference between groups on the primary outcome measure. There was a statistically significant correlation between the primary outcome measure and the scores on the Family Impact Module of the Pediatric Quality of Life Inventory (ρ = 0.57; p <0.0001). Children with better outcomes lived with families reporting better function at 6 months post injury. CONCLUSIONS:: Although no significant effect of the intervention was demonstrated, this study represents the first conducted in Latin America that documents the complete course of treatment for pediatric patients with traumatic brain injury spanning hospital transport through hospital care and into the postdischarge setting.

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