American journal of surgery · 2026
Impact of socioeconomic distress on mortality in pediatric head injury: A geographic and demographic analysis using the Florida Trauma Registry.
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Chalfant Victor, Draus John M, Letton Robert W, Stec Andrew A, Gurien Lori
Аннотация
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of pediatric death in the United States. The Distressed Community Index (DCI) quantifies socioeconomic distress. We evaluated the association between DCI and mortality after pediatric head injury using a statewide registry.
METHODS: Florida trauma registry data (2016-2023) were queried for patients <18 years with ICD-10 S00-S09 diagnoses and known injury zip code. Zip codes were linked to DCI scores and categorized as high distress (>75) or low distress (≤75). Propensity score matching (PSM) reduced confounding, and mortality was compared with Kaplan-Meier analysis.
RESULTS: Among 20,360 patients, 3,569 lived in high-distress communities. Patients had more suspected non-accidental trauma, greater injury severity, and complications. After PSM, high distress was associated with increased mortality (OR 1.40, 95% CI 1.06-1.84; p = 0.021).
CONCLUSIONS: Socioeconomic distress is associated with higher short-term mortality after pediatric head injury, highlighting the need for targeted EMS, hospital protocols, and policy interventions.
METHODS: Florida trauma registry data (2016-2023) were queried for patients <18 years with ICD-10 S00-S09 diagnoses and known injury zip code. Zip codes were linked to DCI scores and categorized as high distress (>75) or low distress (≤75). Propensity score matching (PSM) reduced confounding, and mortality was compared with Kaplan-Meier analysis.
RESULTS: Among 20,360 patients, 3,569 lived in high-distress communities. Patients had more suspected non-accidental trauma, greater injury severity, and complications. After PSM, high distress was associated with increased mortality (OR 1.40, 95% CI 1.06-1.84; p = 0.021).
CONCLUSIONS: Socioeconomic distress is associated with higher short-term mortality after pediatric head injury, highlighting the need for targeted EMS, hospital protocols, and policy interventions.