Black children experience worse clinical and functional outcomes after traumatic brain injury: An analysis of the national pediatric trauma registry
Black children experience worse clinical and functional outcomes after traumatic brain injury: An analysis of the national pediatric trauma registry
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DOI：
10.1097/ta.0b013e31803c760e
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发表时间：
2007-05-01
影响因子：
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通讯作者：
Cornwell, Edward E., III
中科院分区：
文献类型：
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作者：
Haider, Adil H.;Efron, David T.;Cornwell, Edward E., III
背景最近的研究表明，在治疗和创伤性脑损伤（TBI）儿童的结果种族差异。本研究的目的是确定基于种族的临床和功能的结果差异之间的儿童TBI患者在national database.Methods：共41,122例（年龄2-16岁）谁被列入国家儿科创伤登记（1996-2001年）进行了研究。根据相对头部损伤严重程度评分（RHISS）对TBI进行分类，并纳入中度至重度TBI患者。个别种族组进行了比较与白色作为多数组。使用多元逻辑回归分析确定了种族间在三个领域（言语、运动和进食）的功能结果差异。调整年龄，性别，头部损伤的严重程度（使用RHISS），损伤的严重程度（使用新的损伤严重程度评分和儿科创伤评分），发病前，机制，和伤害intention.Results：共有7,778名儿童中度或重度TBI或无相关损伤。所有种族都有相似的人口统计数据。西班牙裔（n = 1，041）的结局与白人（n = 4，762）相当。黑人儿童（n = 1，238）有显著增加的发病前，穿透性创伤，暴力意图。他们也有更高的未经调整的死亡率和更长的平均重症监护室和楼层停留。校正后，黑人和白色儿童的死亡几率没有差异。然而，黑人患者更有可能出院到住院康复设施，并增加了几率，拥有一个功能缺陷在出院的所有三个域studied.Conclusion：黑人儿童创伤性脑损伤有更差的临床和功能的结果，在出院时相比，同等受伤的白色儿童。
Background. Recent studies suggest racial disparities in the treatment and outcomes of children with traumatic brain injury (TBI). This study aims to identify race-based clinical and functional outcome differences among pediatric TBI patients in a national database.Methods: A total of 41,122 patients (ages 2-16 years) who were included in the National Pediatric Trauma Registry (from 1996-2001) were studied. TBI was categorized by Relative Head Injury Severity Score (RHISS) and patients with moderate to severe TBI were included. Individual race groups were compared with white as the majority group. Differences between races in functional outcomes at discharge in three domains-speech, locomotion, and feeding-were determined using multiple logistic regression. Cases were adjusted for age, sex, severity of head injury (using RHISS), severity of injury (using New Injury Severity Score and Pediatric Trauma Score), premorbidities, mechanism, and injury intent.Results: A total of 7,778 children had moderate or severe TBI with or without associated injuries. All races had similar demographics. Hispanics (n = 1,041) had outcomes comparable to whites (n = 4,762). Black children (n = 1,238) had significantly increased premorbidities, penetrating trauma, and violent intent. They also had higher unadjusted mortality and longer mean intensive care unit and floor stays. After adjustment, there was no difference in the odds of death between black and white children. However, black patients were more likely to be discharged to an inpatient rehabilitation facility and had increased odds of possessing a functional deficit at discharge for all three domains studied.Conclusion: Black children with traumatic brain injury have worse clinical and functional outcomes at discharge when compared with equivalently injured white children.