Citation

Liao CC, Chang HC, Yeh CC, Chou YC, Chiu WT, Chen TL. J. Trauma Acute Care Surg. 2012; 73(5): 1327-1331.

Affiliation

From the Department of Anesthesiology (C.-C.L., H.-C.C., T.-L.C.), Taipei Medical University Hospital, Taipei, Taiwan; Health Policy Research Center (C.-C.L., H.-C.C., T.-L.C.), Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine (C.-C.L., H.-C.C., T.-L.C.), Taipei Medical University, Taipei, Taiwan; Department of Surgery (C.-C.Y.), China Medical University Hospital, Taichung, Taiwan; Department of Physical Medicine and Rehabilitation (Y.-C.C.), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Injury Prevention and Control (W.T.C.), Taipei Medical University, Taipei, Taiwan.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e31826fc87f

PMID

23117388

Abstract

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.

Language: en