Research Reports - Socioeconomic deprivation and associated risk factors of traumatic brain injury in children

J Trauma Acute Care Surg. 2012 Nov;73(5):1327-1331

Liao CC, Chang HC, Yeh CC, Chou YC, Chiu WT, Chen TL

BACKGROUND: This study aimed to investigate the relative risks of low income
(family socioeconomic deprivation) and associated factors for traumatic brain
injury (TBI) in children. METHODS: Using Taiwan National Health Insurance
Research Database and adjusting the covariates, we conducted a population-based
case-control study analyzing 8,291 pediatric patients, aged 0 year to 17 years,
diagnosed with TBI, and 33,164 sex- and age-matched controls to study the
association of low income and TBI. The relative risks of TBI for
socioeconomically deprived children with various coexisted medical conditions
were evaluated. RESULTS: After adjustment, pediatric population with low income
were at increased risk of TBI (odds ratio [OR], 1.71; 95% confidence interval
[CI], 1.52-1.92). Among the coexisting medical conditions, low-income pediatric
population with mental disorders had significantly increased TBI risk when
compared with matched controls (adjusted OR, 1.99; 95% CI, 1.51-2.63). Increased
risk of TBI was also found in low-income children with epilepsy when compared
with children of regular family income (adjusted OR, 3.11; 95% CI, 1.65-5.86).
The adjusted OR of TBI for low-income children with mental disorders and epilepsy
was as high as 4.45 (95% CI, 1.96-10.1). Among TBI patients, low-income children
who had epilepsy were at significantly higher risk of post-TBI intracranial
hemorrhage when compared with controls (OR, 10.6; 95% CI, 3.30-33.9). CONCLUSION:
We found a significantly increased risk of TBI in socioeconomically deprived
children, particularly among children with mental disorders, epilepsy, or both.
Low-income children should be considered for special attention to reduce TBI risk
and post-TBI morbidities. LEVEL OF EVIDENCE: Prognostic study, level III.

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