Is Pre-injury Socioeconomic Status Associated with Clinical Outcomes in Patients with Traumatic Brain Injury? A Systematic Review

Introduction: While socioeconomic status (SES) is associated with a variety of health outcomes , the literature on the association between SES and traumatic brain injury (TBI) outcomes has not been formally compiled. This study aims to review existing literature to ascertain whether patients with low SES pre-injury have worse clinical outcomes following TBI compared with those with high SES.

Methods: A systematic search was conducted using the MEDLINE, Embase, and PsychINFO databases. Observational studies published from 2000 to 2022 addressing the association between SES and TBI outcomes were included and results were summarized using PRISMA guidelines. Both pediatric and adult TBI groups were included. Outcomes related to mortality, global neurologic status, vocational outcomes, and cognition were reported.

Results: Thirty-two studies met the inclusion criteria. Measures of SES varied across studies. Mortality was assessed in seven studies; five reported an association between low SES and higher mortality. Five out of eight studies showed an association between low SES and worse global neurologic outcomes; results for cognitive (N = 13) and vocational outcomes (N=10) were mixed.

Conclusion : The results of this review suggest that SES may be a factor contributing to TBI outcomes and should be assessed at time of admission. This information may be used to assist in social work discharge planning and for early mobilization of available community resources.