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

J Trauma Acute Care Surg. 2012 Nov;73(5):1327-31. doi: 10.1097/TA.0b013e31826fc87f.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brain Injuries / complications
  • Brain Injuries / epidemiology*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Epilepsy / complications
  • Female
  • Humans
  • Infant
  • Male
  • Mental Disorders / complications
  • Poverty*
  • Risk Factors
  • Social Class*
  • Taiwan / epidemiology