Functional outcomes during inpatient rehabilitation for American Indian and Alaska Native children with traumatic brain injury.
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.



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.



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).



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.
Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.|Harborview Injury Prevention and Research Center, Seattle, WA, USA.
Molly M
MM
Fuentes
Harborview Injury Prevention and Research Center, Seattle, WA, USA.|Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Nathalia
N
Jimenez
Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
Susan D
SD
Apkon
Harborview Injury Prevention and Research Center, Seattle, WA, USA.|Department of Pediatrics, University of Washington, Seattle, WA, USA.|Department of Epidemiology, University of Washington, Seattle, WA, USA.
Frederick P
FP
Rivara
D000293:Adolescent; D000072957:Alaska Natives; D000070642:Brain Injuries, Traumatic / Q000208:ethnology / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D065246:Culturally Competent Care; D016208:Databases, Factual; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006760:Hospitalization; D006801:Humans; D007198:Indians, North American; D007223:Infant; D016014:Linear Models; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D044465:White People
Alaska Native; American Indian; Native Americans; Traumatic brain injury; pediatric rehabilitation