Role of Race and Age in Traumatic Injury Recovery

Survival rates after traumatic injury differed between blacks and whites

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Aspects of people’s genetic makeup, life experiences and lifestyles may point to how well they will recover from health crises, including traumatic injury. Race and age may be among those factors.

In a recent study, older blacks more easily bounced back after traumatic injury than did older whites who had the same kind of traumatic injury.

But when it came to younger trauma patients, the opposite was true. Among the young, whites who had a traumatic injury rebounded more readily than blacks who sustained similar injuries.

"Protect yourself from traumatic injury."

Caitlin Hicks, MD, MS, of the Johns Hopkins School of Medicine in Baltimore, MD, was this study’s lead author.

For this investigation, Dr. Hicks and her research team analyzed medical records of more than 1 million persons listed in the Nationwide Inpatient Sample, a database of hospital admissions, to determine who survived and who died after being hospitalized for trauma. Those injuries involved severe blunt force or an instrument that penetrated their flesh. More than half the injuries were accidental.

The 1 million individuals had been admitted to hospitals from January 2003 through December 2010. These individuals included 571,028 patients who were 65 years and older and 502,167 who were 16 to 64 years old.

Of the group whose members were at least 65 years old, 95.8 percent were white, 71.1 percent were female, and 99.4 percent had health insurance. More than half of those aged 65 and older group had one or more pre-existing illnesses. Of the younger patients, 82.3 percent were white, 67.2 percent were male, 82.4 percent had health insurance, and 19.3 percent had pre-existing illnesses.

Among those aged 65 and older, the odds of dying after a traumatic injury were 1.21 times higher for whites than for blacks, these researchers found. For patients aged 16 to 64, the odds of dying from trauma were 0.83 times higher for blacks than for whites.

Of all the patients aged 65 and older, 3.4 percent died from their injuries. That compared to 1.8 percent of the younger patients dying from their injuries.

Dr. Hicks and team wrote that they were somewhat baffled by the racial differences in survival rates. But those differences should be highlighted because they “may lead to a better understanding of the mechanisms that cause disparities in trauma outcomes.”

These researchers hypothesized that having access to Medicare, the federal government’s medical insurance for those aged 65 and older, may be partly responsible for the higher survival rates among blacks in that age group versus the lower rates for younger blacks.

Because information on differences in health outcomes between whites and other minority groups is less available, these researchers wrote that they did not include those groups in this study.

This study was published online May 28 in JAMA Surgery.

The National Institutes of Health and American College of Surgeons funded this study.

One of the study’s eight authors reported receiving book royalties and speaker fees related to intensive medical care.

Review Date: 
May 28, 2014
Last Updated:
May 29, 2014