Research Reports - Disparities in disability after traumatic brain injury among Hispanic children and adolescents

Pediatrics. 2013 Jun;131(6):e1850-6

Jimenez N, Ebel BE, Wang J, Koepsell TD, Jaffe KM, Dorsch A, Durbin D, Vavilala MS, Temkin N, Rivara FP

OBJECTIVE: To compare the extent of disability in multiple areas of functioning
after mild, moderate, and severe traumatic brain injury (TBI) between Hispanic
and non-Hispanic white (NHW) children.
METHODS: This was a prospective cohort study of children aged <18 years treated
for a TBI between March 1, 2007, and September 30, 2008. Hispanic (n = 74) and
NHW (n = 457) children were included in the study. Outcome measures were
disability in health-related quality of life, adaptive skills, and participation
in activities 3, 12, 24, and 36 months after injury compared with preinjury
functioning. We compared change in outcome scores between Hispanic and NHW
children at each follow-up time. All analyses were adjusted for age, gender,
severity and intent of injury, insurance, family function at baseline, parental
education, and income.
RESULTS: The health-related quality of life for all children was lower at all
follow-up times compared with baseline. Although NHW children showed some
improvement during the first 3 years after injury, Hispanic children remained
significantly impaired. Significant differences were also observed in the domains
of communication and self-care abilities after TBI. Differences between groups in
scores for participation in activities were also present but were only
significant 3 months after injury.
CONCLUSIONS: Hispanic children with TBI report larger and long-term reductions in
their quality of life, participation in activities, communication, and self-care
abilities compared with NHW children. The reasons for these differences need to
be better understood and interventions implemented to improve the outcomes of
these children.

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