S176 S290
Results:
In 56 percutaneous discal biopsy (52% patients) were positive
in 28 cases. 28/68 were found to be acute cases versus 40 which were
chronic cases. 23 patients were discharged home, 31 went to a SNF, 11
went to medicine, and 3 were transferred to surgery after leaving the
rehab unit. The most common modalities for pain management were
opioids, specifically, Morphine. Out of all the vertebrae regions that
were affected (cervical, lumbar, thoracic, sacral), the lumbar verte-
brae were the most common location of the spinal malignancy in our
patient population. Particularly, the L5-S1 vertebrae were seen to be
affected the most. Comorbid diseases were present in 50 (73%) of 68
patients.
Conclusions:
The average FIM score upon admission was 68 and
increased to 71.85 at discharge.
Level of Evidence:
Level II
PEDIATRICS POSTER HALL: ORIGINAL RESEARCH
Poster 128:
Unmet Rehabilitation Needs After Traumatic Brain
Injury in School-Aged Children
Molly M. Fuentes, MD, FAAPMR (Harborview Injury Prevention and
Research, Seattle, WA, United States), Jin Wang, PhD, MS,
Juliet Haarbauer-Krupa, PhD, Keith O. Yeates, PhD,
Frederick P. Rivara, MD, MPH
Disclosures:
Molly Fuentes: I Have No Relevant Financial Relationships
To Disclose
Objective:
Examine service utilization and risk factors for unmet
service needs 6, 12, and 24 months after traumatic brain injury (TBI) in
school-aged children.
Design:
Prospective cohort study.
Setting:
Six United States hospitals.
Participants:
Children 8 to 18 years old, hospitalized with compli-
cated mild (n
¼
123) or moderate-severe TBI (n
¼
47).
Interventions:
Not applicable.
Main Outcome Measures:
Dysfunction and service need was defined
for multiple domains as scores 10 points below reported pre-injury
baseline on the following scales: Pediatric Quality of Life Inventory;
Patient Reported Outcomes Measurement Information System
(PROMIS) Mobility, Anxiety, and Depression subscales; TBI-QoL Execu-
tive Function and Communication subscales; Neuro-QoL Pediatric
Applied Cognition subscale; Post-Traumatic Stress Disorder Reaction
Index. At 6, 12, and 24 months post-TBI, children were classified as
having no need, need met, or unmet need for physical, occupational,
speech, and mental health therapies, school accommodations, and
rehabilitation medicine.
Results:
Dysfunction varied by domain and injury severity. Nearly half
reported academic dysfunction and 40% cognitive dysfunction two
years after TBI. Over 50% had unmet need for rehabilitation medicine
services; 39% had unmet need for school accommodations; over 25%
had unmet need for speech therapy. Factors independently associated
with unmet need included older age (odds ratio (OR) 3.2 (95% confi-
dence interval (CI) 1.1-11.3)) for speech therapy) and time since TBI
(OR 4.4 (95% CI 1.3-15.6) for physical therapy). Moderate-severe TBI
was associated with less unmet need compared to mild complicated
TBI across domains. Compared to annual household income below
$50,000, income above $50,000 was associated with less unmet need
for physical therapy (OR 0.3 (95% CI 0.1-0.8)) and rehabilitation
medicine (OR 0.2 (95% CI 0.1-0.5)).
Conclusions:
A notable proportion of children with complicated mild
to severe TBI have unmet need for rehabilitative and school services to
improve function in cognitive, communication and academic skills.
Further research should investigate the mechanisms influencing
healthcare utilization patterns after pediatric TBI.
Level of Evidence:
Level II
Poster 131:
Comparison of Post-Concussive Total Symptom Scores
on ImPACT Testing by Demographic Data
Sumita Sharma, BS Psychology (University of Missouri - Kansas City,
Kansas City, MO, United States), Suzan Lisenby, BA,
Ashley K. Sherman, MA, Matthew J. McLaughlin, MD, MS, FAAPMR
Disclosures:
Sumita Sharma: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To determine correlation between number of concussions
and demographic data to amount of symptoms gathered from Imme-
diate Post-Concussion Assessment and Cognitive Test (ImPACT) in the
pediatric population.
Design:
This is a retrospective cohort analysis of pediatric patients
with identified history of concussion between January 2015 until
August 1, 2016. Patient population was identified by presence of data
in the ImPACT databases. Data review consisted of age, gender, edu-
cation level, quality of student, performance on ImPACT testing, and
total symptom score.
Setting:
Tertiary outpatient pediatric hospital.
Participants:
Patient population includes ages 12 to 35 who presented
to concussion clinic, were documented by rehabilitation providers of
having a diagnosis of concussion, and received ImPACT testing.
Interventions:
Not applicable.
Main Outcome Measures:
Total symptom scores from impact testing
were evaluated in comparison to number of concussions, age, gender,
education level, and quality of student.
Results:
After analyzing data from 356 patients, female gender was
noted to be statistically significant (p
<
.0001) when comparing total
symptom scores to male gender by Wilcoxon rank sums test. 186 fe-
males and 170 males and we found that the median symptom score of
females and males were 23 (standard deviation 28.095) and 9
(standard deviation 23.460), respectively. No statistically significant
differences were found regarding total symptom score with regard to
age, presence of premorbid attention-deficit hyperactivity disorder,
reported quality of student, or prior number of concussions.
Conclusions:
Overall, this study found that female gender had higher
total symptoms scores on ImPACT testing compared to males in the
post-concussion population. Future studies may need more patients in
sub-groups to determine if other contributors are equally significant.
Level of Evidence:
Level III
Poster 135:
Developmental Outcomes in Children with Autism
Spectrum Disorder of Different Cognitive Functions
Tzu-Ling Chang (Chang Gung Memorial Hospital-Linkou, Tao-yuan,
Taiwan, Taiwan), Chia-ling Chen, MD, PhD, Chia-Ying Chung, MD
Disclosures:
Tzu-Ling Chang: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To investigate developmental outcomes in children with
autism spectrum disorder (ASD) of different cognitive functions.
Design:
A cross-sectional study.
Setting:
An outpatient clinic of a tertiary teaching hospital.
Participants:
Thirty-five children with ASD (2-7 years) were collected
in this study. All participation was classified into two groups based on
the scores in cognition domain of the Pediatric Functional Indepen-
dence Measure: mild (the score in the cognition domain
S
4, n
¼
14)
and severe groups (the score in the cognition domain
<
4, n
¼
21).
Interventions:
Not applicable.
Main Outcome Measures:
Developmental outcomes were measured
with Comprehensive Developmental Inventory for Infants and Toddlers
(CDIIT). The developmental quotients (DQs) were calculated as
developmental age divided by chronological age. An independent t
test was used to compare the outcomes between two groups. A p
<
.05
was considered to be statistically significant.
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Abstracts / PM R 9 (2017) S131-S290