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

Chien Chang Liao, Huai Chia Chang, Chun Chieh Yeh, Yi Chun Chou, Wen Ta Chiu, Ta Liang Chen

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1327-1331
Number of pages5
JournalJournal of Trauma and Acute Care Surgery
Volume73
Issue number5
DOIs
Publication statusPublished - Nov 2012

Fingerprint

Odds Ratio
Confidence Intervals
Epilepsy
Poverty
Pediatrics
Traumatic Brain Injury
Social Adjustment
Intracranial Hemorrhages
National Health Programs
Taiwan
Mental Disorders
Case-Control Studies
Databases
Morbidity
Research
Population
Neurodevelopmental Disorders

Keywords

  • Children
  • Epilepsy
  • Low income
  • Mental disorders
  • Socioeconomic deprivation
  • Traumatic brain injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Socioeconomic deprivation and associated risk factors of traumatic brain injury in children. / Liao, Chien Chang; Chang, Huai Chia; Yeh, Chun Chieh; Chou, Yi Chun; Chiu, Wen Ta; Chen, Ta Liang.

In: Journal of Trauma and Acute Care Surgery, Vol. 73, No. 5, 11.2012, p. 1327-1331.

Research output: Contribution to journalArticle

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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.",
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AU - Chen, Ta Liang

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N2 - 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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