Brain injury: Functional outcome in children with tracheostomies and gastrostomies

Mark L. Splaingard*, Deborah J Gaebler-Spira, Peter Havens, Miriam Kalichman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Survival, functional outcome, placement, and need for appliances at six and 24 months after either anoxic metabolic encephalopathies (AME) or traumatic head injuries (TI) were determined in 36 children with both tracheostomies and gastrostomies who were discharged from acute care hospitals. Five deaths occurred in totally dependent children with both tracheostomies and gastrostomies in place. Ten of 22 children with TI (48% of survivors) achieved independence in three functional areas by two years, whereas none of 14 with AME achieved functional independence in any area at two years (p = 0.001). Only one of the 18 who were dependent in all three areas at six months achieved partial independence in any area on reevaluation at two years. Institutionalization at two years was strongly predicted by six-month functional status (p < 0.01). Four of 18 children dependent at six months returned to home care by two years, whereas all 16 children who achieved partial independence within six months of insult were cared for at home at two years (p < 0.001), regardless of age or injury type. The need for tracheostomy at two years correlated with functional status at six months (p < 0.01). Two-year survival was unexpectedly high for this group of children when compared to studies in adults. Functional status at six months is a strong predictor of dependency and institutionalization at two years.

Original languageEnglish (US)
Pages (from-to)318-321
Number of pages4
JournalArchives of Physical Medicine and Rehabilitation
Volume70
Issue number4
StatePublished - Jan 1 1989

Keywords

  • Brain damage
  • Brain injuries
  • Gastrostomy
  • Outcome
  • Pediatrics
  • Tracheostomy

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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