摘要：Objectives. We examined the burden of disability resulting from traumatic brain injuries (TBIs) among children younger than 18 years. Methods. We derived our data from a cohort study of children residing in King County, Washington, who were treated in an emergency department for a TBI or for an arm injury during 2007–2008. Disabilities 12 months after injury were assessed according to need for specialized educational and community-based services and scores on standardized measures of adaptive functioning and social–community participation. Results. The incidence of children receiving new services at 12 months was about 10-fold higher among those with a mild TBI than among those with a moderate or severe TBI. The population incidence of disability (defined according to scores below the norm means on the outcome measures included) was also consistently much larger (2.8-fold to 28-fold) for mild TBIs than for severe TBIs. Conclusions. The burden of disability caused by TBIs among children is primarily accounted for by mild injuries. Efforts to prevent these injuries as well as to decrease levels of disability following TBIs are warranted. Traumatic brain injuries (TBIs) are the most common cause of death from trauma among children and adolescents 1 and one of the most common causes of acquired disability. 2 TBI surveillance systems have provided important aggregate information on the incidence of these injuries. 3 Studies conducted in hospitals and rehabilitation centers have provided information on medical care 4 and rehabilitation of patients with TBIs and their resultant impairments, focusing on those with more severe TBIs. 5 However, population-based estimates of subsequent disability after pediatric TBIs are lacking. This population-based information is important to guide TBI prevention efforts and to ensure appropriate planning and delivery of services to children with TBIs who have special needs. Although much of the focus in the literature has been on severe TBIs, concerns about the consequences of concussions and mild TBIs have recently increased in both the medical literature and the lay press. 6 Available data indicate that mild TBIs are much more common than moderate or severe TBIs, 7,8 and thus even if the consequences for most injured individuals are much less serious, mild TBIs have the potential to contribute a large share to the overall population TBI burden. In this study, we examined the burden of disability resulting from TBIs occurring among children younger than 18 years.
