Child Opportunity Index Predicts Outcomes in Pediatric Spine Trauma: A Novel Application of Socioeconomic Metrics

Social factors play a crucial role in health outcomes for pediatric patients, yet in the neurosurgery pediatric literature, these factors are rarely reported. To develop a deeper understanding of pediatric spine trauma outcomes we investigate demographic and social factors measured by the Child Opportunity Index (COI) and Social Deprivation Index (SDI). We hypothesize that socioeconomic factors predict clinical presentation, injury severity, and clinical outcomes. Methods: We conducted a retrospective cohort study of pediatric patients treated for spinal trauma at a Level 1 trauma center in Sacramento, California. We collected patient clinical data such as mechanisms of injury (MOI), length of stay (LOS), treatment type, hospital disposition, polytrauma incidence, and follow-up attendance. Each patient’s socioeconomic environment was characterized using COI and SDI metrics. Statistical comparisons were performed to assess associations between socioeconomic factors and clinical outcomes. Results: Patients with lower socioeconomic status (SES) (lower COI and higher SDI) were more likely to be insured through Medi-Cal, identify as Hispanic, and experience violent MOI. Female patients were more likely to sustain polytrauma and had a higher likelihood of requiring surgical intervention. Additionally, patients from underserved communities demonstrated longer hospital stays and poorer follow-up adherence, with COI and SDI scores significantly correlating with these disparities. Conclusion: Socioeconomic disparities are significantly associated with outcomes in pediatric spine trauma. We found COI and SDI to be valuable clinical metrics, motivating further research to be done at a state and national level. These findings highlight health disparities in pediatric spine trauma.