Impact of socioeconomic distress on mortality in pediatric head injury: A geographic and demographic analysis using the Florida Trauma Registry.

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.