Establishing Valid Criteria for Classification of Mild Traumatic Brain Injury in Children

Epidemiological and longitudinal research on prediction and outcomes in traumatic brain injury (TBI) relies on a standard, validated definition of the severity of injury. However, such a validated definition is not available for mild injury. The definition in the literature of mild traumatic brain injury (MTBI) remains highly variable. Moreover, these definitions have primarily focused on adults, not children. This study completes a secondary analysis on data collected during the ABI Transitions Study (a longitudinal study which followed children/youth who were admitted to McMaster Children's Hospital with brain injury). This study used various advanced statistical techniques in hopes to answer the research question: What are the criteria that distinguish children with a MTBI from those with moderate and severe injuries?

The main objectives of the study are:

• to investigate improved definitions of MTBI in terms of predicted trajectories of change in outcomes meaningful to children and families with TBI,
  
• to investigate the multivariate pattern of clinical variables on admission that best define mild impairments, in terms of the prediction of subsequent trajectories of change in outcomes,
  
• to distinguish which children (among children with Glasgow Coma Scale Score of 13 to 15 on admission) are expected to have difficulties in one or more areas of function and to identify clinical variables that distinguish these children, and
  
• to identify patterns in routinely collected clinical data that can differentiate the distinct groups of children who differ in the degree of severity of injury resulting in more accurate classification of injury severity.
  

Research Team

Impact

The findings of this study have potential to provide the basis for recommendations regarding: the definition of MTBI in children, the intervention and follow-up services for children with MTBI, the policy regarding funding programs and services for childhood ABI particularly mild injuries, and the education of family, clinicians and others.

Funder

Ontario Neurotrauma Foundation