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Requirements for and current provision of rehabilitation services for children after severe acquired brain injury in the UK: a population-based study

Lookup NU author(s): Dr Louise HayesORCiD, Professor Mark PearceORCiD, Dr Rob ForsythORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by BMJ Group, 2017.

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Objectives Survival with brain injury is an outcome of severe illness that may be becoming more common. Provision for children in this situation has received little attention. We sought to estimate rates of severe paediatric Acquired Brain Injury (ABI) requiring rehabilitation and to describe current provision of services for these children in the UK Methods Analysis of Hospital Episode Statistics data between April 2003 and March 2012; supplemented by a UK provider survey completed in 2015. A Probable Severe ABI Requiring Rehabilitation (PSABIR) event was inferred from the co-occurrence of a medical condition likely to cause ABI (such as meningitis) and a prolonged inpatient stay (>= 28 days). Results During the period studied, 4508 children aged 1-18 years in England had PSABIRs. Trauma was the most common cause (30%) followed by brain tumours (19%) and anoxia (18.3%). An excess in older males was attributable to trauma. We estimate the incidence of PSABIR to be at least 2.93 (95% confidence interval 2.62-3.26) per 100,000 young people (1-18 years) pa. The provider survey confirmed marked geographic variability in the organisation of services in the UK. Conclusions There are at least 350 Probable Severe ABI Requiring Rehabilitation events in children in the UK annually, a health problem of similar magnitude to that of cerebral palsy. Service provision for this population varies widely around the UK, in contrast with the nationally-coordinated approach to paediatric intensive care and major trauma provision.

Publication metadata

Author(s): Hayes L, Shaw S, Pearce MS, Forsyth RJ

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood

Year: 2017

Volume: 102

Issue: 9

Pages: 813-820

Print publication date: 01/09/2017

Online publication date: 17/04/2017

Acceptance date: 22/03/2017

Date deposited: 24/03/2017

ISSN (print): 0003-9888

Publisher: BMJ Group


DOI: 10.1136/archdischild-2016-312166


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