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.
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