# Impact of childhood traumatic brain injury on educational attainment in Finland from 1998 to 2018: a retrospective register-based nationwide cohort study

## TL;DR

This study found that childhood traumatic brain injuries in Finland are linked to lower educational attainment compared to those with non-brain injuries.

## Contribution

The study is the first nationwide cohort analysis linking pTBI to reduced odds of achieving tertiary education.

## Key findings

- pTBI patients had 15% lower odds of attaining any tertiary education compared to the reference group.
- pTBI patients were 19% less likely to attain higher tertiary education than lower tertiary education.
- Specific intracranial injuries were associated with a 22% lower odds of attaining any tertiary education compared to concussions.

## Abstract

Pediatric traumatic brain injury (pTBI) can lead to considerable mortality, morbidity, mental impairment, and physical disability over time. The direct impact of pTBI on educational attainment is unclear. We included all pediatric 0- to 17-year-old patients who were at least 26 years old at the end of the follow-up with a diagnosis of TBI in the Finnish Care Registry for Health Care (years 1998 to 2018) to form our study group (pTBI group). The reference group comprised patients with ankle and wrist fractures. The pTBI group was further divided into concussions and specific intracranial injuries. We compared this information to Statistics Finland´s Degree/Qualification data to evaluate educational attainment at 3 main levels. All comparisons were made using logistic regression with 95% confidence intervals (CI). The pTBI group comprised 8 487 patients and the reference group comprised 15,552 patients. In total, 7594 pTBI patients had a concussion and 892 a specific intracranial injury. The pTBI group had lower odds of attaining any tertiary education compared with the reference group (odds ratio [OR] 0.85; CI 0.80, 0.90). The pTBI group was also more likely to remain at a lower tertiary education than attain higher tertiary education (OR 0.81; CI 0.74, 0.87). Patients with specific intracranial injuries were more likely not to attain any tertiary education compared to patients with concussions (OR 0.78; CI 0.68, 0.90). People with pTBI had lower educational attainment at all higher educational levels than the reference population with ankle and wrist injuries.