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The Impact of Social Deprivation on Pediatric PROMIS Health Scores After Upper Extremity Fracture

Ugochi C Okoroafor1, William Gerull1, Melissa Wright1

  • 1Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO.

The Journal of Hand Surgery
|September 21, 2018
PubMed

Insights

Social deprivation negatively impacts children's perceived health and function, affecting upper extremity function, mobility, pain, and peer relations. Interventions are needed for children, not just adults.

Area of Science:

  • Pediatric Orthopedics
  • Public Health
  • Health Outcomes Research

Background:

  • Social deprivation is known to affect adult health.
  • Its impact on children's perceived health and function is less understood.
  • This study investigates social deprivation's effect on pediatric patients with upper extremity fractures.

Purpose of the Study:

  • To evaluate the impact of social deprivation on Patient-Reported Outcomes Measurement Information System (PROMIS) scores in children with upper extremity fractures.
  • To determine if social deprivation influences perceived health and function in pediatric patients.
  • To identify specific PROMIS domains affected by social deprivation in children.

Main Methods:

  • Cross-sectional analysis of 975 pediatric patients (8-17 years) with upper extremity fractures.
  • Utilized Patient-Reported Outcomes Measurement Information System (PROMIS) Computer Adaptive Tests (CATs).
  • Quantified social deprivation using the Area Deprivation Index and compared outcomes between most and least deprived quartiles.

Main Results:

  • Children from the most socially deprived areas (34%) reported significantly worse PROMIS scores for Upper Extremity Function, Mobility, Pain Interference, and Peer Relations compared to those from the least deprived areas (21%).
  • A higher proportion of Black children were identified in the most socially deprived quartile.
  • No significant differences in patient age, sex, or fracture type were observed between the groups.

Conclusions:

  • Social deprivation significantly impacts children's perceived health and function, evident even before adulthood.
  • Worse outcomes in upper extremity function, mobility, pain interference, and peer relations are reported by children in highly deprived areas.
  • Interventions to mitigate the negative effects of social deprivation should be extended to children.
Abstract

Keywords:
PROMISSocial deprivationfracturepediatricupper extremity

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