Pediatric disability weights following injury based on patient-reported data from a multinational cohort

Empirical data on post-injury disability in children is limited and deriving disability weights is urgently needed. The aim of this study is to utilise pooled data to determine adequate disability weights in children and adolescents. Five longitudinal prospective cohort studies of pediatric injury survivors aged 5–17 years were pooled (N = 1972) to create case-based pediatric weights for established nature-of-injury classifications using four types of EQ-5D utility scores to represent overall health-related quality of life. Healthy population norms from seven countries formed a sensitivity analysis. Disability weights (DW) were calculated at 1 month, 4 months, 6 months, and 12 months post injury to produce two disability weights per injury class: 12-month residual disability weights (12dw) and 12-month annualised weights (12aw). DW for asphyxiation/non-fatal submersion, spinal cord lesion, fracture of the femur, fracture of pelvis, and fracture of vertebral column, were more than twice that of the lowest DW for fracture of clavicle, scapula, or humerus, and fracture of radius or ulna. 12dw for moderate/severe traumatic brain injury (TBI) was 19% higher than minor TBI and 25% higher for 12aw. Conclusion: Different DW should be applied to DALY calculations for children and adolescents compared to adults. The calculation of these DWs is complex and warrants further investigation. This study confirms that injury is often a chronic disorder and burden of disease for children and adolescents and estimates should reflect this situation.