Agitation in the setting of pediatric traumatic brain injury
CPS ePoster Library. Hicks R. Jun 1, 2017; 176632
Rhiannon Hicks
Rhiannon Hicks
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Abstract
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Background: Agitation following traumatic brain injury (TBI) commonly occurs during the acute phase of recovery and has been shown to hinder rehabilitation.

Objectives: The current study investigated the relationships between acute agitation, injury severity, gender, disability, and functional outcomes in pediatric patients with TBI.This was done using the Agitation Behaviour Scale (ABS), which is being validated for use in children as part of this study.

Methods: 26 children (ages 5-17) with TBI participated in the study as part of the Attention and Outcome Following TBI study. The ABS was completed 3 times daily for 4 days and total mean agitation was calculated for analysis. Injury severity was measured by PRISM III, MRI score, Glasgow Coma Scale, Pediatric Trauma score, and length of intubation. Functional outcomes at baseline and 12 months post-TBI were measured by the Pediatric Injury Functional Outcome Scale. Relationships between injury severity, functional outcomes and agitation were analyzed with Spearman's rank correlation coefficients. Intellectual and physical disability was measured at baseline and 12 months after TBI using the Pediatric Cerebral Performance Category and patients were categorized according to disability severity. Mean agitation was compared between gender and disability groups with one-way ANOVAs.

Results: There was a significant positive association between agitation and duration of ventilation, (ρ= 0.752, P< 0.001). Higher levels of agitation were also displayed by children who had a higher risk of mortality due to their injury, (ρ= 0.465, P= 0.017). There was a trend towards significance between agitation and trauma severity, where children that suffered more traumatic injury showed increased agitation (ρ= -0.382, P= 0.054). In addition, a trend between agitation and long-term functional outcome was found, where more agitated children had increased functional deficits 12 months post-TBI (ρ= 0.445, P=0.084). There were no significant differences in agitation between genders or disability groups at baseline and 12 months post-TBI.Conclusion: The ABS is a useful tool in the investigation of potential predictors and outcomes of agitation during TBI recovery in the pediatric population, which may facilitate development of improved management strategies in the future.

Conclusion: The ABS is a useful tool in the investigation of potential predictors and outcomes of agitation during TBI recovery in the pediatric population, which may facilitate development of improved management strategies in the future.

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