Race May Play Role in Trauma Patient Deaths

Higher mortality rate found among trauma patients at minority hospitals

(RxWiki News) Race may play a role in surviving severe trauma. Hospitals that primarily serve minorities appear to have higher death rates when it comes to treating trauma patients.

Additional studies will be needed, however, to verify if other factors contributed such as transportation to the hospital, preexisting conditions and each hospital's adherence to trauma treatment policies.

"For a serious injury, go to a level one trauma center."

Dr. Adil H. Haider, a physician at the Johns Hopkins School of Medicine, wrote that if the research is confirmed, certain hospitals could be targeted for performance improvement initiatives to reduce disparities experienced by racial and ethnic minorities.

Researchers analyzed the records of 311,569 patients between 2007 and 2008 through the National Trauma Data Bank. Patients were between the ages of 18 and 64 and were white, black or Hispanic. Each had severe trauma and was treated at one of 434 hospitals.

The hospitals were categorized by the percentage of minority trauma patients admitted. Hospitals considered predominantly minority tended to have younger patients of which fewer were women, have more patients with knife or gunshot wounds and the highest rate of mortality from any cause.

After adjusting for various factors, the odds of dying increased by 16 percent in hospitals with 25 percent to 50 percent minority patients. It increased by 37 percent in hospitals with more than 50 percent minority patients as compared to hospitals that regularly treat patients where 25 percent or less are minorities.

Within a subgroup of patients with blunt injury, patients were 45 percent more likely to die at hospitals that predominantly treat minorities.

Black and Hispanic youth tend to be at a higher risk for violence with many of these populations residing in the same areas and going to the same hospitals. Recognizing the problem could help lead to increased training, staff and support for such facilities.

Investigators suggest that hospitals that serve a population that tends to be more than 50 percent minority and a high proportion of uninsured patients should be the focus of initiatives to financially strengthen them. Such a move could reduce racial disparities in trauma outcomes and improve care for all patients, they concluded.

The research was published online first by Archives of Surgery, one of the Journal of the American Medical Association/Archives journals.

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Review Date: 
September 22, 2011