Fatigue Following Traumatic Brain Injury in Children and Adolescents: A Longitudinal Follow-Up 6 to 12 Months after Injury

Background: Longitudinal fatigue data in children suffering from traumatic brain injury (TBI) are lacking. Objectives: To examine the effects of time postinjury (6-12 months) and injury severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12 months postinjury against published control data. Setting: Three tertiary children's hospitals across Australia (n = 1) and Canada (n = 2). Participants: Parents (n = 109) of children (mean [M] = 9.9 years at injury; range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n = 69) or moderate/severe (n = 37) TBI. Design: Longitudinal prospective study. Measures: Primary: Pediatric Quality of Life Multidimensional Fatigue Scale (total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic and children data were collected at recruitment. Results: Mixed-models analysis demonstrated nonsignificant effects of time (6 vs 12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue worsened over time. Moderate/severe TBI was associated with worse fatigue 12 months postinjury (general, P =.03; cognitive, P =.02). Across all severities, fatigue 12 months postinjury was significantly worse compared with control data (total fatigue, P <.001; all domains, all Ps <.025). Conclusion: Fatigue remains significant at 12 months since injury, particularly for those with moderate/severe TBI.