Effect of parental education and household poverty on recovery after traumatic brain injury in school-aged children,Brain Injury

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Effect of parental education and household poverty on recovery after traumatic brain injury in school-aged children
Brain Injury ( IF 1.9 ) Pub Date : 2021-09-16 , DOI: 10.1080/02699052.2021.1972141
Mark R Zonfrillo ₁ , Juliet Haarbauer-Krupa ₂ , Jin Wang _{3,

4} , Dennis Durbin ₅ , Kenneth M Jaffe _{3,

6} , Nancy Temkin ₇ , Michael Bell ₈ , David S Tulsky ₉ , Hilary Bertisch ₁₀ , Keith Owen Yeates ₁₁ , Frederick P Rivara _{3,

4,

9}

Affiliation

Departments of Emergency Medicine and Pediatrics, Hasbro Children's Hospital and the Alpert Medical School of Brown University, Providence, Rhode Island, USA.
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
The Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Department of Pediatrics, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, Ohio, USA.
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Departments of Neurological Surgery and Biostatistics, University of Washington, Seattle, Washington, USA.
Departments of Pediatrics, Children's National Medical Center, Washington, DC, USA.
Center on Assessment Research and Translation, Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA.
The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, New York.
Department of Psychology, Hotchkiss Brain Institute, and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, USA.

ABSTRACT

Objective

While prior studies have found parental socioeconomic status (SES) affects the outcomes of pediatric traumatic brain injury (TBI), the longitudinal trajectory of this effect is not well understood.

Methods

This prospective cohort study included children 8–18 years of age admitted to six sites with a complicated mild (n = 123) or moderate-severe TBI (n = 47). We used caregiver education and household poverty level as predictors, and multiple quality of life and health behavior domains as outcomes. Differences at 6, 12, and 24 months from baseline ratings of pre-injury functioning were compared by SES. We examined the association between measures of SES and domains of functioning over the 24 months post-injury in children with a complicated mild or moderate- severe TBI, and determined how this association varied over time.

Results

Parental education was associated with recovery among children with complicated mild TBI; outcomes at 6, 12, and 24 months were substantially poorer than at baseline for children with the least educated parents. After moderate-severe TBI, children in households with lower incomes had poorer outcomes compared to baseline across time.

Implications

Parental education and household income were associated with recovery trajectories for children with TBI of varying severity.

中文翻译：

父母教育和家庭贫困对学龄儿童脑外伤后康复的影响

摘要

客观的

虽然先前的研究发现父母的社会经济地位 (SES) 会影响小儿创伤性脑损伤 (TBI) 的结果，但这种影响的纵向轨迹尚不清楚。

方法

这项前瞻性队列研究包括 8-18 岁的儿童，这些儿童被收治在 6 个患有复杂轻度 (n = 123) 或中重度 TBI (n = 47) 的地点。我们使用照顾者教育和家庭贫困水平作为预测因素，并使用多个生活质量和健康行为领域作为结果。通过 SES 比较了 6、12 和 24 个月与损伤前功能基线评级的差异。我们检查了患有复杂轻度或中重度 TBI 的儿童在受伤后 24 个月内 SES 测量值与功能领域之间的关联，并确定了这种关联如何随时间变化。