Black Children Experience Worse Clinical and Functional Outcomes After Traumatic Brain Injury: An Analysis of the National Pediatric Trauma Registry
- 1 May 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Trauma-Injury Infection and Critical Care
- Vol. 62 (5), 1259-1263
- https://doi.org/10.1097/ta.0b013e31803c760e
Abstract
Recent studies suggest racial disparities in the treatment and outcomes of children with traumatic brain injury (TBI). This study aims to identify race-based clinical and functional outcome differences among pediatric TBI patients in a national database. A total of 41,122 patients (ages 2–16 years) who were included in the National Pediatric Trauma Registry (from 1996–2001) were studied. TBI was categorized by Relative Head Injury Severity Score (RHISS) and patients with moderate to severe TBI were included. Individual race groups were compared with white as the majority group. Differences between races in functional outcomes at discharge in three domains—speech, locomotion, and feeding—were determined using multiple logistic regression. Cases were adjusted for age, sex, severity of head injury (using RHISS), severity of injury (using New Injury Severity Score and Pediatric Trauma Score), premorbidities, mechanism, and injury intent. A total of 7,778 children had moderate or severe TBI with or without associated injuries. All races had similar demographics. Hispanics (n = 1,041) had outcomes comparable to whites (n = 4,762). Black children (n = 1,238) had significantly increased premorbidities, penetrating trauma, and violent intent. They also had higher unadjusted mortality and longer mean intensive care unit and floor stays. After adjustment, there was no difference in the odds of death between black and white children. However, black patients were more likely to be discharged to an inpatient rehabilitation facility and had increased odds of possessing a functional deficit at discharge for all three domains studied. Black children with traumatic brain injury have worse clinical and functional outcomes at discharge when compared with equivalently injured white children.Keywords
This publication has 13 references indexed in Scilit:
- Racial Disparities in Health Outcomes After Spinal Cord Injury: Mediating Effects of Education and IncomeThe Journal of Spinal Cord Medicine, 2006
- Ethnic and Racial Disparities in Emergency Department Care for Mild Traumatic Brain InjuryAcademic Emergency Medicine, 2003
- Contribution of Major Diseases to Disparities in MortalityNew England Journal of Medicine, 2002
- Traumatic Brain Injury in the Elderly: Increased Mortality and Worse Functional Outcome At Discharge Despite Lower Injury SeverityJournal Of Trauma-Injury Infection and Critical Care, 2002
- Factors Influencing Admission among Children with a Traumatic Brain InjuryAcademic Emergency Medicine, 2002
- A Modification of the Injury Severity Score That Both Improves Accuracy and Simplifies ScoringJournal Of Trauma-Injury Infection and Critical Care, 1997
- Equivalence Reliability of the Functional Independence Measure for Children (WeeFIM®) Administration MethodsAmerican Journal of Occupational Therapy, 1997
- WeeFIMClinical Pediatrics, 1994
- Use of Functional Assessment in Children with Developmental DisabilitiesPhysical Medicine and Rehabilitation Clinics of North America, 1993
- The pediatric trauma score as a predictor of injury severity in the injured childJournal of Pediatric Surgery, 1987