Allawos, Kestrel
(2022)
Impact of Social Deprivation Index on Severe Traumatic Brain Injury Outcomes.
Master Essay, University of Pittsburgh.
Abstract
Severe Traumatic Brain Injury (TBI) is a considerable public health concern worldwide, as it is one of the leading causes of death and disability among young people. Even with extensive research on the subject, there are many unknowns regarding risk factors for recovery from severe TBI, and much of the outcome variability is unaccounted for. Neurobehavioral recovery is particularly difficult to predict using current models. After examining the literature to find established and potential risk factors for TBI outcomes, the aim was to see if there is any association between social determinants of health and global, functional, or neurobehavioral outcomes from 3 months to 2 years post-hospitalization in a sample of 287 participants. Post-injury outcomes were measured and recorded by a clinical technician at 3, 6, 12, and 24 months using three scales: the Glasgow Outcome Score (GOS), the Disability Rating Score (DRS), and the Neurobehavioral Rating Score (NRS). These three measures as well as reported death (yes/no) at timepoints 3, 6, 12, and 24 months were included in this analysis. Social Deprivation Index (SDI) was used as a way to quantify unmeasured social determinants of health based on patients’ 5-digit zip codes. A series of regressions were performed, which included age, sex, Glasgow Coma Score (GCS), and SDI as predictors, to determine any association between these variables and the outcome measures. Based on this analysis, there was no evidence that SDI is associated with TBI recovery, though the association between SDI and NRS at 6-months did approach statistical significance. Age and GCS were both significantly associated with recovery, with higher age and lower GCS correlating to worse recovery. Missing data was a concern in this sample, and there was evidence of an association between higher SDI and more missing data, which may have impacted the results for the group with high SDI. Further research could use a larger, more diverse sample and additional ways to identify and quantify social determinants of health to try and parse out the differential recovery patterns that are seen in TBI patients.
Share
| Citation/Export: |
|
| Social Networking: |
|
Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Committee Chair | Conley, Yvette | yconley@pitt.edu | yconley | UNSPECIFIED | | Committee Member | Shaffer, John | john.r.shaffer@pitt.edu | john.r.shaffer | UNSPECIFIED |
|
| ETD Committee: |
|
| Date: |
16 May 2022 |
| Date Type: |
Completion |
| Defense Date: |
2022 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
57 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Public Health Genetics |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
social determinants, traumatic brain injury, outcome variability |
| Date Deposited: |
16 May 2022 13:37 |
| Last Modified: |
16 May 2024 05:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/42742 |
Metrics
Monthly Views for the past 3 years
Plum Analytics
Actions (login required)
 |
View Item |
![[feed]](/images/feed-icon-32x32.png){kind=icon}