BACKGROUND & AIMS: OBJECTS:Optic nerve sheath diameter has been linked with intracranial pressure in previous studies. Measurement of sheath diameter using transorbital ultrasound is proposed as a clinical assessment indicator of developing hydrocephalus in the paediatric population. METHODS:A retrospective review of optic nerve sheath ultrasound examinations performed in a clinical setting between 2000 and 2006 for assessment of hydrocephalus in a single institution. RESULTS:A total of 331 examinations were performed in 160 patients over the study period. A satisfactory image was possible in all cases. Sheath diameters were correlated with clinical case data from concurrent case records. CONCLUSION:Transorbital ultrasound is a reproducible, non-invasive technique for the assessment of optic nerve sheath diameter and is well tolerated in children. Our series revealed asymptomatic baseline value higher than in previous reports. Variation from individual case asymptomatic baseline was the most sensitive variable in the series in determining development of hydrocephalus. This technique is felt to be a useful adjunct in the assessment of hydrocephalus in the paediatric neurosurgical population.

背景与目标：

BACKGROUND & AIMS: :The aim was to clarify the developmental nature of associations between psychiatric illness and risk for cardiovascular disease by investigating differences in cardiac functioning between youth with anxiety disorders and healthy controls. Twenty-two children meeting DSM-IV criteria for either separation anxiety disorder, overanxious disorder, panic disorder/panic attacks, or social phobia and 12 healthy controls underwent continuous electrocardiogram and respiration rate monitoring during a 15 min baseline period and 15 min of exposure to 5% CO(2). Heart rate (HR) and high frequency heart rate variability (HRV), a non-invasive measure of cardiac parasympathetic control, were calculated. Youth with anxiety disorders had higher and less fluctuating HR during baseline. Data also suggested that probands showed diminished overall changes in HRV during baseline and CO(2) inhalation relative to controls. However, as respiration rate affects HRV, these findings were confounded by changes in respiration elicited by CO(2) inhalation. The data suggest that youth with anxiety disorders experience an elevated and less fluctuating HR in the face of a novel situation, possibly due to a failure to appropriately modulate HRV. In adults, sustained elevations in HR in conjunction with deficient vagal modulation predicts risk for future cardiovascular disease. As such, the current data suggest that the presence of an anxiety disorder may identify youth who exhibit autonomic profiles that place them at risk for cardiac disease.

背景与目标： : 目的是通过调查焦虑症青年与健康对照者之间心脏功能的差异，阐明精神疾病与心血管疾病风险之间关联的发展性质。22名符合dsm-iv标准的分离焦虑症，过度焦虑症，恐慌症/惊恐发作或社交恐惧症的儿童和12名健康对照者在15分钟的基线期和15分钟的暴露期间接受了连续心电图和呼吸频率监测5% CO(2)。计算了心率 (HR) 和高频心率变异性 (HRV)，这是一种非侵入性的心脏副交感神经控制措施。焦虑症的青年在基线期间的HR波动较高，且波动较小。数据还表明，先证者显示，相对于对照组，基线和CO(2) 吸入期间HRV的总体变化减少。然而，由于呼吸速率会影响HRV，因此这些发现被CO(2) 吸入引起的呼吸变化所混淆。数据表明，面对新情况，患有焦虑症的年轻人的HR升高且波动较小，这可能是由于未能适当调节HRV所致。在成人中，HR的持续升高与迷走神经调节不足相结合可预测未来心血管疾病的风险。因此，当前的数据表明焦虑症的存在可能会识别出表现出自主神经特征的年轻人，这使他们有患心脏病的风险。

BACKGROUND & AIMS: :The study tested the prevalence of graft vessel disease (GVD) in 54 paediatric heart transplant (HTx) patients (32 male, age 0-17 years) who underwent coronary angiographic investigations (N=117). These were evaluated according to the Stanford classification and additional criteria (peripheral obliterations, diameter fluctuations, pathologic tapering) were applied for risk assessment (no GVD/minimal lesions, GVD without Stanford lesions, accelerated GVD). In H&E stainings from right ventricular endomyocardial biopsies (EMB=169) diagnosis of acute cellular rejection (ACR, ISHLT) and microvasculopathy were performed. Mild rejection was found in 43% (N=44) and severe rejection in 7% (N=7) of EMB early (1st year) and mild rejection in 31% (N=32) and severe in 8% (N=9) late (>3 years) after HTx. Microvasculopathy was present in 22% of EMB. Risk assessment of coronary angiographies showed no GVD/minimal disease in 25% (N=29), GVD without Stanford lesions in 12% (N=14) and different grades of accelerated GVD in 74% (N=74) of studies. All patients dying due to cardiac related causes of death (N=6, 3-12 years after HTx) had evidence of GVD. The data show GVD to be an important cause of late cardiac related deaths in this population.

背景与目标： : 该研究测试了54例接受冠状动脉造影检查 (N = 117) 的小儿心脏移植 (HTx) 患者 (32名男性，年龄0-17岁) 的移植物血管疾病 (GVD) 的患病率。根据Stanford分类对这些进行评估，并将其他标准 (外周闭塞，直径波动，病理渐缩) 用于风险评估 (无GVD/最小病变，无Stanford病变的GVD，加速GVD)。在右心室心内膜活检 (EMB = 169) 的H & E染色中，进行了急性细胞排斥 (ACR，ISHLT) 和微血管病变的诊断。在EMB早期 (1年) 的43% (N = 44) 中发现轻度排斥反应，在7% (N = 7) 中发现严重排斥反应，在31% (N = 32) 中发现轻度排斥反应，在HTx后晚期 (>3年) 中发现严重排斥反应。EMB 22% 存在微血管病变。冠状动脉造影的风险评估显示，在25% (N = 29) 中没有GVD/最小疾病，在12% (N = 14) 中没有斯坦福病变的GVD，在74% (N = 74) 的研究中没有不同程度的加速GVD。所有因心脏相关死亡原因死亡的患者 (HTx后6年，3-12年) 都有GVD的证据。数据显示GVD是该人群晚期心脏相关死亡的重要原因。

BACKGROUND & AIMS: BACKGROUND:Undifferentiated embryonal sarcomas of the liver (UESL) are extremely rare and continue to pose a diagnostic and therapeutic challenge. The aim of the study was to present a multicenter experience of the German CWS and Polish PPSTG groups in the treatment of UESL in children. PROCEDURE:Twenty-five patients were treated according to the CWS-96, CWS-2002, and CYVADIC protocols. Distant metastases were observed in four cases (16%). In four cases, an initial disease presentation mimicked other entities. A pure cystic appearance of liver mass led to misdiagnosis of hydatid cyst in three cases. In one case, laparotomy was performed due to the signs of appendicitis, and bleeding from ruptured liver tumor was found. All these patients were finally diagnosed as UESL. RESULTS:Thirteen patients received preoperative chemotherapy. Partial response was observed in 10 cases. Tumor resection was performed in 20 patients (primary resections, 12; delayed resections-, 8). In five patients, the primary tumor never became operable. The macroscopically complete resection rate was 95% (19/20). Postoperative chemotherapy was given to 20 children. Local radiotherapy was used in three children. After a median follow-up time of 136 months, 17 patients (68%) were alive with no evidence of disease. All children with unresectable tumor and three out of four patients with distant metastases died. The five-year overall survival (OS) rate was 72%. CONCLUSIONS:In summary, a complete tumor excision plays the central role in the treatment of UESL. A cystic presentation of the liver lesion on imaging does not exclude the diagnosis of malignant tumor.

背景与目标：

BACKGROUND & AIMS: :The anaesthetic management of children with craniofacial abnormalities often presents unique challenges because soft tissue and bony abnormalities can affect the airway and influence airway management. We report four paediatric patients with predicted difficult airways due to craniofacial abnormalities. They all had a laryngeal view of Cormack-Lehane grade IV and were impossible to intubate using direct laryngoscopy. Fibreoptic intubation was also repeatedly attempted but was not successful. All the tracheal intubations were completed using a lightwand on the first attempt in less than 30 s. We consider that lightwand guided intubation technique may be a useful alternative approach to fibreoptic intubation technique in managing the difficult paediatric airway.

背景与目标： : 颅面异常儿童的麻醉管理通常会带来独特的挑战，因为软组织和骨异常会影响气道并影响气道管理。我们报告了四名因颅面异常而预计气道困难的儿科患者。他们都具有Cormack-Lehane IV级的喉部视图，并且无法使用直接喉镜检查进行插管。也反复尝试过光纤插管，但未成功。在不到30 s的第一次尝试中，所有气管插管均使用lightwand完成。我们认为，在管理困难的儿科气道方面，lightwand引导的插管技术可能是光纤插管技术的有用替代方法。

BACKGROUND & AIMS: :The combination of pediatric cardiology being both a perceptual and a cognitive subspecialty demands a complex decision-making model which makes artificial intelligence a particularly attractive technology with great potential. The prototypical artificial intelligence system would autonomously impute patient data into a collaborative database that stores, syncs, interprets and ultimately classifies the patient's profile to specific disease phenotypes to compare against a large aggregate of shared peer health data and outcomes, the current medical body of literature and ongoing trials to offer morbidity and mortality prediction, drug therapy options targeted to each patient's genetic profile, tailored surgical plans and recommendations for timing of sequential imaging. The focus of this review paper is to offer a primer on artificial intelligence and paediatric cardiology by briefly discussing the history of artificial intelligence in medicine, modern and future applications in adult and paediatric cardiology across selected concentrations, and current barriers to implementation of these technologies.

背景与目标： : 儿科心脏病学既是感知专业又是认知专业的结合，需要一个复杂的决策模型，这使人工智能成为具有巨大潜力的特别有吸引力的技术。原型人工智能系统将自动将患者数据输入到协作数据库中，该数据库存储，同步，解释并最终将患者的概况分类为特定的疾病表型，以与大量共享的同伴健康数据和结果进行比较，当前的医学文献和正在进行的试验提供发病率和死亡率预测，针对每个患者的遗传特征的药物治疗选择，量身定制的手术计划以及顺序成像时机的建议。本文的重点是通过简要讨论人工智能在医学中的历史，成人和儿科心脏病学在选定浓度范围内的现代和未来应用以及当前实施这些技术的障碍，来提供有关人工智能和儿科心脏病学的入门知识。

BACKGROUND & AIMS: BACKGROUND:The magnitude of cardiovascular morbidity in paediatric, adolescent, and young adult survivors of Hodgkin's lymphoma is not known. Using medically ascertained data, we applied the cumulative burden metric to compare chronic cardiovascular health conditions in survivors of Hodgkin's lymphoma and general population controls. METHODS:For this study, participant data were obtained from two ongoing cohort studies at St Jude Children's Research Hospital: the St Jude Lifetime Cohort Study (SJLIFE) and the St Jude Long-term Follow-up Study (SJLTFU). SJLIFE is a cohort study initiated on April 27, 2007, to enable longitudinal clinical evaluation of health outcomes of survivors of childhood cancer treated or followed at St Jude Children's Research Hospital, and SJLTFU is an administrative system-based study initiated in 2000 to collect outcome and late toxicity data for all patients treated at the hospital for childhood cancer. The patient cohort for our study was defined as patients treated at St Jude Children's Research Hospital who reached 18 years of age and were at least 10 years post-diagnosis of pathologically confirmed primary Hodgkin's lymphoma. Outcomes in the Hodgkin's lymphoma survivors were compared with a sample of SJLIFE community control participants, aged 18 years or older at the time of assessment, frequency-matched based on strata defined by 5-year age blocks within each sex, who were selected irrespective of previous medical history. All SJLIFE participants underwent assessment for 22 chronic cardiovascular health conditions. Direct assessments, combined with retrospective clinical reviews, were used to assign severity to conditions using a modified Common Terminology Criteria of Adverse Events (CTCAE) version 4.03 grading schema. Occurrences and CTCAE grades of the conditions for eligible non-SJLIFE participants were accounted for by multiple imputation. The mean cumulative count (treating death as a competing risk) was used to estimate cumulative burden. FINDINGS:Of 670 survivors treated at St Jude Children's Research Hospital, who survived 10 years or longer and reached age 18 years, 348 were clinically assessed in the St Jude Lifetime Cohort Study (SJLIFE); 322 eligible participants did not participate in SJLIFE. Age and sex frequency-matched SJLIFE community controls (n=272) were used for comparison. At age 50 years, the cumulative incidence of survivors experiencing at least one grade 3-5 cardiovascular condition was 45·5% (95% CI 36·6-54·3), compared with 15·7% (7·0-24·4) in community controls. The survivor cohort at age 50 experienced a cumulative burden of 430·6 (95% CI 380·7-480·6) grade 1-5 and 100·8 (77·3-124·3) grade 3-5 cardiovascular conditions per 100 survivors; these numbers were appreciably higher than those in the control cohort (227·4 [192·7-267·5] grade 1-5 conditions and 17·0 [8·4-27·5] grade 3-5 conditions per 100 individuals). Myocardial infarction and structural heart defects were the major contributors to the excess grade 3-5 cumulative burden in survivors. High cardiac radiation dose (≥35 Gy) was associated with an increased proportion of grade 3-5 cardiovascular burden, whereas increased anthracyline dose was not. INTERPRETATION:The true effect of cardiovascular morbidity in paediatric, adolescent, and young adult survivors of Hodgkin's lymphoma is reflected in the cumulative burden. Survivors aged 50 years will experience more than two times the number of chronic cardiovascular health conditions and nearly five times the number of more severe (grade 3-5) cardiovascular conditions compared with community controls and, on average, have one severe, life-threatening, or fatal cardiovascular condition. The cumulative burden metric provides a more comprehensive approach for assessing overall morbidity compared with currently used cumulative incidence based analytic methodologies, and will assist clinical researchers when designing future trials and refining general practice screening guidelines. FUNDING:US National Cancer Institute, St Baldrick's Foundation, and American Lebanese Syrian Associated Charities.

背景与目标：

BACKGROUND & AIMS: PURPOSE:Surgical approach to children with complicated ureteral duplication is discussed controversially. Our aim was to determine the outcome of children with complicated renal duplication undergoing a single-stage surgical approach with laparoscopic partial nephrectomy and open bladder reconstruction. METHODS:Data of patients from 2004 to 2008 were investigated retrospectively. Outcome was analyzed in terms of postoperative course, renal function, urinary tract infection and functional voiding. RESULTS:Thirteen patients were treated with laparoscopic partial nephrectomy and reconstruction of the lower urinary tract in a single-stage approach. Median age at operation was 15 months (2-63 m). One girl had a renal triplication. 7/13 patients presented with an ectopic ureterocele, two with an ectopic ureter, severe vesicoureteral reflux occurred in 6 patients. All patients had non-functioning renal moieties. Mean operative time was 239 min (129-309; SD 50). One re-operation was necessary 4 years after primary surgery due to a pole remnant. All patients had uneventful recoveries without evidence of recurrent UTI. Postoperative 99mTc-MAG3 scans showed no significant reduction of partial renal function (p = 0.4), and no signs of obstruction (p = 0.188). During a median follow-up of 60 months (49-86), dysfunctional voiding occurred in one patient. CONCLUSIONS:In children with complicated ureteral duplication a definitive single-stage procedure is feasible and shows excellent functional results.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:Double checking medications at initial assessment within paediatric emergency departments (EDs) has the potential to delay patient flow, and doubt has been cast on the efficacy of double checking in all but high-risk medications. We aimed to benchmark current practice for the use of Patient Group Direction (PGD) medications at initial assessment in EDs within the Paediatric Emergency Research UK and Ireland (PERUKI) network, with a focus on the use of 'single-checker' PGDs. METHODS:Online survey was distributed to the research representative at each PERUKI site. The survey was open for 5 weeks (from March 2015 to April 2015) and was completed by any appropriate clinician within the site. RESULTS:The response rate was 84% (36/43 EDs). From these, 22 out of 36 (61%) EDs were using single-checker PGDs. The commonest single-checked medications in use were paracetamol and ibuprofen for pain. Among PERUKI sites, 21.9% of EDs reported drug errors related to standard (double-checked) PGDs, whereas 13.6% of those with single-checked PGDs reported drug errors (Fisher's exact test with significance level of 0.05, P=0.501). The commonest errors reported were duplicated dose, incorrect weight, incorrect volume drawn up, contraindication missed. CONCLUSION:Single-checker PGDs are currently in use in nearly two-thirds of PERUKI sites. No evidence of increased medication errors was reported with this practice; however, more detailed studies are required to support this finding and to inform best practice.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Central line-associated bloodstream infections (CLABSIs) are major contributors to preventable harm in the inpatient paediatric setting. Despite multiple guidelines to reduce CLABSI, sustaining reliable central line maintenance bundle compliance remains elusive. We identified frontline and family engagement as key drivers for this initiative. The baseline CLABSI rate for all our paediatric inpatient units (January 2016-January 2017) was 1.71/1000 central line days with maintenance bundle compliance at 87.9% (monthly range 44%-100%). OBJECTIVE:To reduce CLABSI by increasing central line maintenance bundle compliance to greater than 90% using kamishibai card (K-card) audits and family 'key card' education. METHODS:We transitioned our central line maintenance bundle audits from checklists to directly observed K-card audits. K-cards list the central line maintenance bundle elements to be reviewed with frontline staff. Key cards are cue cards developed using a plain-language summary of CLABSI K-cards and used by frontline staff to educate families. Key cards were distributed to families of children with central lines to simultaneously engage patients, families and frontline staff after a successful implementation of the K-card audit process. A survey was used to obtain feedback from families. RESULTS:In the postintervention period (February 2017-December 2019), our CLABSI rate was 0.63/1000 central line days, and maintenance bundle compliance improved to 97.1% (monthly range 86%-100%, p<0.001). Of the 45 family surveys distributed, 20 (44%) were returned. Nineteen respondents (95%) reported being extremely satisfied with the key card programme and provided positive comments. CONCLUSION:Combining the key card programme with K-card audits was associated with improved maintenance bundle compliance and a reduction in CLABSI. This programme has the potential for use in multiple healthcare improvement initiatives.

背景与目标：

BACKGROUND & AIMS: :There is increasing concern about the emerging global non-communicable diseases (NCDs) burden. The focus has mainly been on NCDs in adults but it is important that MSK morbidity in both children and adults is included in strategic planning. There have been considerable advances in the understanding and treatment options for children and young people (CYP) and clinical outcomes are improving for those who can access such high quality care. However vast inequity exists and there are many CYP who live in areas of the world with high burden of health care challenges, compounded by paucity of specialist care and limited access to treatments. The Paediatric Global Musculoskeletal Task Force aims to raise awareness about unmet needs for CYP with MSK conditions, promotion of MSK health through lifestyle and the avoidance of injury. We aim to leverage change through 'working together better'.

背景与目标： : 人们越来越担心正在出现的全球非传染性疾病负担。重点主要放在成人的非传染性疾病上，但重要的是将儿童和成人的MSK发病率纳入战略规划。儿童和年轻人 (CYP) 的理解和治疗选择有了很大的进步，对于那些能够获得这种高质量护理的人来说，临床结果正在改善。然而，存在着巨大的不平等现象，并且有许多CYP生活在世界上医疗保健挑战负担沉重的地区，而专家护理的匮乏和获得治疗的机会有限。儿科全球肌肉骨骼工作组旨在提高人们对MSK条件下CYP未满足需求的认识，通过生活方式和避免伤害来促进MSK健康。我们的目标是通过 “更好地合作” 来利用变革。

BACKGROUND & AIMS: :This study examined induction and recovery times and respiratory and cardiovascular changes during induction and recovery in paediatric patients undergoing anaesthesia under spontaneous respiration induced with sevoflurane (S group, n = 10) and halothane (H group, n = 9) at 2.4 MAC. FET/FI increased more rapidly, the incidence of breath holding and coughing was less and the recovery time was shorter in the S group compared with the H group. During induction with sevoflurane at 2.4 MAC, min vol/bodyweight decreased due to reduced tidal vol/bodyweight despite increased respiratory frequency, as with halothane at the same MAC. Slight decrease in blood pressure was observed during induction in the S group, while the circulatory depression was not observed during induction in the H group. These results suggest that sevoflurane is a suitable agent for induction under spontaneous respiration with higher concentrations in paediatric anaesthesia.

背景与目标： : 这项研究检查了在七氟醚 (S组，n = 10) 和氟烷 (H组，n = 9) 在2.4 MAC的自发呼吸下接受麻醉的儿科患者的诱导和恢复时间以及诱导和恢复期间的呼吸和心血管变化。与H组相比，S组FET/FI增加更快，屏气和咳嗽的发生率更少，恢复时间更短。在2.4 MAC下用七氟醚诱导期间，尽管呼吸频率增加，但由于潮气体积/体重降低，min体积/体重降低，与相同MAC下的氟烷一样。S组在诱导过程中观察到血压略有下降，而H组在诱导过程中未观察到循环抑制。这些结果表明，七氟醚是小儿麻醉中较高浓度的自发呼吸诱导的合适药物。

BACKGROUND & AIMS: OBJECTIVE:To study the characteristics of paediatric emergency demand and care delivery in the emergency room of a community hospital. DESIGN:Analysis of the care demand and medical attention given to pediatric patients in an emergency room during 2006. Retrospective review of patients' medical reports. SETTING:Emergency room, Hospital da Barbanza, Riveira, A Coruña, Spain. PARTICIPANTS:Random selection of 1330 patients from 3990 cases attended in 2006. MAIN MEASUREMENTS:Age, sex, time of arrival at the emergency room, type of pathology, medical-surgical area, destination on discharge, which medical staff signed the discharge, and length of stay in the emergency room. RESULTS:There were 731 men and 599 women. Demand was greater on the afternoon shift (45%). Discharge destination was mainly to home (94%), with the emergency medical staff signing it in 60.7% of cases and the pediatrician in 34.6%. Children aged 6 or more suffered mainly from trauma; and younger children, from infectious diseases. There were no statistically significant differences between age groups for length of stay in the emergency room, but patients attended by pediatricians stayed longer. CONCLUSIONS:There was a clear majority of little children, especially boys, in our study. Higher afternoon attendance probably occurs because of greater time availability of parents and children. Main causes of emergency pediatric care are infectious diseases and trauma. The child's home is the most frequent destination on discharge. The fact that most discharges are signed by the emergency doctor, together with the increase in emergency paediatric care in recent years, points to the need for constant updating of this medical area by emergency doctors.

背景与目标：

BACKGROUND & AIMS: :Bronchiectasis has been defined as the abnormal and permanent dilation of bronchi. It has a variety of causes and has traditionally been viewed as a condition that is irreversible, often progressive and associated with significant morbidity and mortality. In the past, patients had relatively advanced disease by the time the diagnosis was established. By using high-resolution computed tomography (HRCT) scanning of the chest, the potential now exists for the much earlier detection and treatment of children with lesser degrees of bronchial dilation and bronchial wall thickening than was previously possible. In some, the HRCT changes have been seen to improve or completely resolve. This calls into question exactly what now should be termed bronchiectasis and how the parents of children with such HRCT findings should be counselled about the likely prognosis and the necessary or desirable treatment options.

背景与目标： 支气管扩张被定义为支气管的异常和永久性扩张。它有多种原因，传统上被视为一种不可逆转的疾病，通常是渐进性的，并伴有显著的发病率和死亡率。过去，在诊断确定时，患者已患有相对晚期的疾病。通过对胸部进行高分辨率计算机断层扫描 (HRCT) 扫描，现在有可能比以前更早地检测和治疗支气管扩张和支气管壁增厚程度较小的儿童。在某些情况下，HRCT的变化已被改善或完全解决。这使人们质疑现在应该将什么称为支气管扩张，以及应如何向具有这种HRCT发现的儿童的父母提供有关可能的预后以及必要或理想的治疗选择的建议。

BACKGROUND & AIMS: INTRODUCTION:Assessing outcomes in the paediatric trauma population is important. Identifying suitable instruments can be problematic. This article highlights the commonly used outcome measures for assessing functional status and health related quality of life in paediatric trauma patients. Child specific characteristics which impact upon instrument development and selection are reviewed. METHODS:An electronic database search was conducted to identify suitable English language measures used for outcome assessment in paediatric trauma patients from 1966 to present. RESULTS:Nine suitable instruments were identified, the child health questionnaire (CHQ), Glasgow outcome scale (GOS), paediatric overall performance category (POPC), PedsQL 4.0 generic core scales, paediatric evaluation of disability inventory (PEDI), functional independence measure (FIM), WeeFIM and an unnamed paediatric trauma specific measure [Gofin R, Hass T, Adler B, The development of disability scales for childhood and adolescent injuries. J Clin Epidemiol 1995;48:977-84]. Each instrument was found to have advantages and disadvantages for assessing outcomes in a paediatric trauma population. CONCLUSION:The PedsQL 4.0 generic core scale could be feasible for administration as a routine outcome measure for paediatric trauma groups. For very young children an additional measure such as that proposed by Gofin et al. [Gofin R, Hass T, Adler B, The development of disability scales for childhood and adolescent injuries. J Clin Epidemiol 1995;48:977-84] may be indicated. Future use of these instruments in the paediatric population would benefit from further psychometric evaluation.

背景与目标：