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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Machine Learning Insights Into Social Determinants Driving Child Abuse in Pediatric Traumatic Brain Injury.

Foad Kazemi1, Melanie Alfonzo Horowitz, David Lee

  • 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore , Maryland , USA.

Neurosurgery
|September 9, 2025
PubMed
Summary

Social determinants of health like unemployment and crowding are linked to suspected child abuse in pediatric TBI patients. Targeted interventions are needed to address these health disparities.

Keywords:
Child abusePediatric traumaSocial determinants of healthTraumatic brain injury (TBI)

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Area of Science:

  • Public Health
  • Pediatric Medicine
  • Health Disparities Research

Background:

  • Social determinants of health (SDOH) significantly contribute to health inequities and disparities in patient outcomes.
  • Addressing SDOH is crucial for mitigating adverse health events, especially in vulnerable pediatric populations.

Purpose of the Study:

  • To examine the association between SDOH and suspected child abuse (SCA) in pediatric patients with traumatic brain injury (TBI).
  • To identify the most influential SDOH measures contributing to SCA using CDC/PLACES data and machine learning.

Main Methods:

  • Retrospective review of pediatric TBI cases (2016-2023) identified via ICD-10 codes.
  • Integration of Centers for Disease Control and Prevention (CDC)/PLACES data on SDOH with institutional TBI data.
  • Multivariate regression and Extreme Gradient Boosting (XGBoost) with SHapley Additive exPlanations (SHAP) to identify key factors associated with SCA.

Main Results:

  • 13.3% of 2945 pediatric TBI patients experienced SCA.
  • Seven of nine SDOH measures and the Social Deprivation Index (SDI) were significantly associated with SCA (P < .01).
  • Unemployment, housing crowding, and minority status were identified as the strongest predictors of SCA, surpassing SDI.

Conclusions:

  • SDOH, specifically unemployment, crowding, and minority status, are strongly associated with SCA in pediatric TBI.
  • Findings underscore the need for targeted interventions to reduce health disparities in child abuse.
  • Public health initiatives should focus on addressing socioeconomic factors to prevent SCA in children with TBI.