Disparities in Disability After Traumatic Brain Injury Among Hispanic Children and Adolescents
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.
- ABAS-II —
- Adaptive Behavior Assessment System–Second Edition
- AIS —
- Abbreviated Injury Scale
- CASP —
- Child and Adolescent Scale of Participation
- CHAI —
- Child Health After Injury
- CT —
- computed tomography
- GCS —
- Glasgow Coma Scale
- PedsQL —
- Pediatric Quality of Life Inventory
- TBI —
- traumatic brain injury
- Accepted February 22, 2013.
- Copyright © 2013 by the American Academy of Pediatrics