Affiliations: [a] Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA | [b] Harborview Injury Prevention and Research Center, Seattle, WA, USA | [c] Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA | [d] Department of Pediatrics, University of Washington, Seattle, WA, USA | [e] Department of Epidemiology, University of Washington, Seattle, WA, USA
Correspondence:
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Corresponding author: Molly M. Fuentes, 325 9th Ave Box 359960, Seattle, WA 98104, USA. Tel.: +1 206 744 9207; E-mail:mollyfue@uw.edu
Abstract: PURPOSE: American Indian/Alaska Native (AI/AN) people have the
highest traumatic brain injury (TBI)-related mortality in the United States,
but little is known about AI/AN children who survive traumatic brain injury
(TBI). This study compares function and factors associated with discharge
function between AI/AN and White children with TBI during inpatient
rehabilitation. METHODS: Retrospective national cohort study of 114 AI/AN and 7,267
White children aged 6 months-18 years who received inpatient TBI
rehabilitation between 2002-2012 at facilities utilizing the Uniform Data
System for Medical Rehabilitation\scriptsize®. The outcome
measure was developmental functional quotients (DFQ is the
FIM\scriptsize® or WeeFIM\scriptsize® score
divided by age norms x 100) at discharge. RESULTS: AI/AN race was not associated with motor (regression
coefficient (β) 0.18, 95% confidence interval (CI) -2.39, 2.76) or
cognitive (β -1.54, 95% CI -3.75, 0.67) function. Among a subgroup
with loss of consciousness > 24 hours (AI/AN n= 13, White n= 643), AI/AN race
was associated with lower motor DFQ (β -12.83, 95% CI -25.39, -0.34). CONCLUSIONS: Overall, AI/AN race was not associated with inpatient
rehabilitation function for children with TBI, but providers should not
assume AI/ANs with more severe injuries have equitable outcomes.
