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

PURPOSE: American Indian/Alaska Native (Al/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 (R). The outcome measure was developmental functional quotients (DFQ is the FIM (R) or WeeFIM (R) score divided by age norms x 100) at discharge. RESULTS: Al/AN race was not associated with motor (regression coefficient (beta) 0.18, 95% confidence interval (CI) -2.39, 2.76) or cognitive (beta -1.54,95% Cl -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 (beta -12.83, 95% CI -25.39, -0.34). CONCLUSIONS: Overall, Al/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.