Long-Term Quality of Life After Pediatric Traumatic Brain Injury Treated in the Intensive Care Unit

Objectives To examine the long-term health-related quality of life (HRQL) after pediatric traumatic brain injury (TBI) treated in the intensive care unit (ICU) Design Multicenter retrospective cohort study Setting Four university hospital ICUs in Finland Patients Children <18 years of age with TBI treated in the ICU during 2003–2013 Interventions None Measurements and Main Results Patients alive at the end of 2020 were sent two different HRQL questionnaires: 15/16-dimensional (15D/16D), RAND-36 (if ≥18y at time of response) and questions regarding chronic diseases, socioeconomical status and the need for healthcare support. HRQL was defined as poor when the 15D/16D score total score was below the age- and sex-matched mean population score in Finland minus the minimal clinically important difference. A total of 150 of 337 (44%) patients responded (n=144 15D/16D responses). Median follow-up time was 11 years. Seventy patients (49%) had a poor HRQL according to 15D/16D score. TBI patients had significantly poorer 15D scores in every dimension as compared to the matched population mean values. A higher Helsinki CT score, mechanical ventilation, and female sex were associated with poor long-term HRQL according to the 15D/16D. Patients with poor 15D/16D scores also needed significantly more healthcare services, medications and had more comorbidities than patients with normal scores. A poor 15D/16D score was associated with lower socioeconomic status. Conclusions Half of long-term pediatric intensive care unit-treated TBI survivors had poor HRQL 11 years after injury. More severe head CT findings at admission and female sex associated with poor HRQL.