Three of four assessments have now been completed to determine health-related quality of life of children and youth aged 0 to 16 years at baseline (pre-injury), one month, & four months post injury. The most striking result so far is that even so-called “minor” injuries (i.e., those treated and released from the emergency department) have a significant influence on health related quality of life well after sustaining an injury. In total 334 participants were enrolled in this study with a primary injury diagnosis identified in the BC Children’s Hospital (BCCH) hospital wards and emergency department; 260 were from the emergency department and 74 from in-patient units of a pediatric hospital in Vancouver, BC.
We have multiple analyses planned for the completed data set including assessments on the impact of health-related quality of life, the presence of Post Traumatic Stress Disorder (PTSD) in both parents and children after injury, the impacts of injury severity, and the use of parent proxy in data collection.
A PhD student has also joined our team and plans to examine the economic burden of injury as well as the role of health services in injury treatment and recovery.
The mean baseline total health score (representing pre-injury health) of participants was found to be 90.37 (+ 10.31). At 1 month these scores dropped to 78.50 (+ 17.63) and by four months the mean PedsQl total health score return to almost that of pre injury status (89.6 + 12.06). In response to ‘current impact,’ 56 parents (40.1%) indicated their child was still affected by their injury at one month, 31 (22.8%) indicated their child was still affected at four months and 26 (18.8%) indicated their child was still affected at twelve months post injury. Of note, 29.4% (10) of the parents of children who had been hospitalized and 15.5% (16) parents of the children who had not been hospitalized indicated their children were still impacted at 12 months, demonstrating the importance of these significantly more common injuries.
A simple logistic regression regressing each demographic/injury variable on the parental response to ‘current impact’ at each time point individually found that at one month, older age, having been hospitalized, and having had an upper or lower extremity fracture are significantly associated with higher odds of reporting remaining impact. At 4 months having been hospitalized and having had a lower extremity fracture remain significant and at 12 months the variable with the strongest relationship with reporting an outstanding impact from the injury is gender with parents of girls having higher odds of reporting an outstanding impact relative to parents of boys (OR 4.16 (1.69 – 10.24)). This relationship remains significant in a multiple logistic regression including hospitalization status and age (as a continuous variable).