Outcomes from Evaluations for Mild Traumatic Brain Injury Pediatric Patients in the Hospital
Melanie B. LaPlant, MPH1; Ashley Strobel, MD2; Andrew Kiragu, MD, FAAP2; Rachel Nygaard, PhD2; Sherrie Murphy, BSN, CEN, CPEN, CPHQ2; Donavon J. Hess, MD, PhD, MBA1
1University of Minnesota, Minneapolis, MN; 2Hennepin County Medical Center, Minneapolis, MN
Introduction: Mild traumatic brain injury (TBI) is frequently diagnosed in children evaluated for injury. Mild TBI patients may manifest signs and symptoms that cause disability and benefit from follow-up evaluation and treatment. We report our experience with isolated mild TBI patients admitted for observation and evaluation.
Methods: We reviewed records for 170 patients under 15 years of age with mild TBI and identified 35 with isolated mild TBI admitted to our level I pediatric trauma center from 01/01/2016 through 12/31/2017. We determined the rate and results of referrals to occupational therapy (OT), speech language pathology (SLP), physical therapy (PT), and social work (SW).
Results: Patient ages ranged from two weeks to 14 years. Of the 35 patients, 34 (97%) were evaluated by OT, 22 (63%) by SLP, nine (26%) by PT, and 34 (97%) by SW. Of those patients referred, deficits were identified in 10 (29%) evaluated by OT, 17 (77%) evaluated by SLP, and one (11%) evaluated by PT. Additionally, seven (21%) of those referred to social work had school interventions planned.
Conclusion: Mild TBI is a condition with variable clinical sequlae that can be difficult to predict. Patients admitted for observation after TBI had appreciable rates of deficits identified upon multidisciplinary assessment. The level of assessment required to identify these deficits would not be available in most outpatient early follow-up. Consideration should be given to admission and multidisciplinary evaluation following mild TBI.
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