AI Article Synopsis
- Traumatic brain injuries (TBIs) are a major concern for children, significantly affecting their health and survival, with socioeconomic factors influencing their severity and outcomes.
- The study analyzed data from over 26,000 pediatric TBI patients, revealing that those with poor socioeconomic status (PSES) were more likely to suffer from violence-related injuries and had worse health outcomes, including higher mortality rates and longer hospital stays.
- The findings suggest that healthcare providers need to consider socioeconomic disparities in their care strategies to improve treatment and resource use for pediatric TBI patients.
Article Abstract
Background: Traumatic brain injuries (TBIs) play a significant role in pediatric mortality and morbidity. Environment may play a role in the type, severity, and outcome of pediatric TBI (pTBI). Our objective was to characterize the impact of poor socioeconomic status (PSES) on the incidence, treatment, and outcomes of pTBI patients.
Methods: The Kids' Inpatient Database (KID) was queried from 2016 to 2019 for with TBI using International Classification of Disease, 10th revision (ICD 10) codes. Data defining demographics, complications, procedures, and outcomes was extracted. PSES was defined as Medicaid insurance and Q1 median income category.
Results: 26,417 patients had pTBI. 11,040 (41.8 %) of pTBI patients were on Medicaid insurance. 13,119 and 8165 (30.9 %) were in Q1 median income category. Land transport caused the majority of pTBI (41 %). Patients on Medicaid or Q1 median income were more likely to experience assault (OR 2.927, CI 95 % 2.455-3.491, p < 0.001 OR 2.033, CI 95 % 1.722-2.4000 p < 0.001 respectively). On propensity matched analysis, PSES was associated with increased mortality (OR 1.667, 95 % CI 1.322-2.100, p < 0.01), length of stay (LOS) (OR 1.369, 95 % CI 1.201-1.559, p < 0.01), and major complicated trauma (OR 1.354 95 % CI 1.090-1.682 p = 0.007). Total hospital charges were higher in pTBI patients on Medicaid ($112,101.52, +/- $203,716.35) versus non-Medicaid ($109,064.37 +/- $212,057.98) (p < 0.001).
Conclusion: PSES is correlated with increased mortality, complications, and longer LOS. Healthcare coverage and clinical training should take these disparities into account to provide improved care and optimize healthcare resource utilization.
Level Of Evidence: Level IV, Retrospective Database.
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| http://dx.doi.org/10.1016/j.clineuro.2022.107404 | DOI Listing |
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