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

## TL;DR

This study calculates disability weights for children and adolescents after injury using multinational data, showing that these weights differ from those used for adults.

## Contribution

The study provides new injury-specific disability weights for children and confirms that injuries are a chronic burden for this population.

## Key findings

- Disability weights for severe injuries like spinal cord lesions were more than twice those for less severe injuries.
- Moderate/severe traumatic brain injury had significantly higher disability weights than minor TBI.
- The study supports the need for distinct disability weights for children compared to adults in disease burden calculations.

## Abstract

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. What is Known:• Traumatic injuries pose substantial threats to children’s health, education and social inclusion• Much-needed disability weights, used in calculating the years lived with disability (YLDs), has been limited by the lack of empirical data on postinjury disability in childrenWhat is New:• This study confirms injury is often a chronic disorder and burden of disease for children and adolescents• Injury-group disability weights for children and adolescents are provided for YLD calculations, and these weights differ to those used for adults

What is Known:

• Traumatic injuries pose substantial threats to children’s health, education and social inclusion

• Much-needed disability weights, used in calculating the years lived with disability (YLDs), has been limited by the lack of empirical data on postinjury disability in children

What is New:

• This study confirms injury is often a chronic disorder and burden of disease for children and adolescents

• Injury-group disability weights for children and adolescents are provided for YLD calculations, and these weights differ to those used for adults

The online version contains supplementary material available at 10.1007/s00431-026-06845-2.