Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action

The health disparities which drive inequities in health outcomes have long plagued our already worn healthcare system and are often dismissed as being a result of social determinants of health. Herein, we explore the nature of these inequities by comparing outcomes for racial and ethnic minorities p...

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Main Authors: Emma A. Richie, Joseph G. Nugent, Ahmed M. Raslan
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-06-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2021.690971/full
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author Emma A. Richie
Joseph G. Nugent
Ahmed M. Raslan
author_facet Emma A. Richie
Joseph G. Nugent
Ahmed M. Raslan
author_sort Emma A. Richie
collection DOAJ
description The health disparities which drive inequities in health outcomes have long plagued our already worn healthcare system and are often dismissed as being a result of social determinants of health. Herein, we explore the nature of these inequities by comparing outcomes for racial and ethnic minorities patients suffering from traumatic brain injury (TBI). We retrospectively reviewed all patients enrolled in the Trauma One Database at the Oregon Health & Science University Hospital from 2006 to October 2017 with an abbreviated injury scale (AIS) for the head or neck >2. Racial and ethnic minority patients were defined as non-White or Hispanic. A total of 6,352 patients were included in our analysis with 1,504 in the racial and ethnic minority cohort vs. 4,848 in the non-minority cohort. A propensity score (PS) model was generated to account for differences in baseline characteristics between these cohorts to generate 1,500 matched pairs. The adjusted hazard ratio for in-hospital mortality for minority patients was 2.21 [95% Confidence Interval (CI) 1.43–3.41, p < 0.001] using injury type, probability of survival, and operative status as covariates. Overall, this study is the first to specifically look at racial and ethnic disparities in the field of neurosurgical trauma. This research has demonstrated significant inequities in the mortality of TBI patients based on race and ethnicity and indicates a substantive need to reshape the current healthcare system and advocate for safer and more supportive pre-hospital social systems to prevent these life-threatening sequelae.
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spelling doaj.art-deaef2e374504c7f881a04494ce9479e2022-12-22T04:15:37ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-06-01810.3389/fsurg.2021.690971690971Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to ActionEmma A. RichieJoseph G. NugentAhmed M. RaslanThe health disparities which drive inequities in health outcomes have long plagued our already worn healthcare system and are often dismissed as being a result of social determinants of health. Herein, we explore the nature of these inequities by comparing outcomes for racial and ethnic minorities patients suffering from traumatic brain injury (TBI). We retrospectively reviewed all patients enrolled in the Trauma One Database at the Oregon Health & Science University Hospital from 2006 to October 2017 with an abbreviated injury scale (AIS) for the head or neck >2. Racial and ethnic minority patients were defined as non-White or Hispanic. A total of 6,352 patients were included in our analysis with 1,504 in the racial and ethnic minority cohort vs. 4,848 in the non-minority cohort. A propensity score (PS) model was generated to account for differences in baseline characteristics between these cohorts to generate 1,500 matched pairs. The adjusted hazard ratio for in-hospital mortality for minority patients was 2.21 [95% Confidence Interval (CI) 1.43–3.41, p < 0.001] using injury type, probability of survival, and operative status as covariates. Overall, this study is the first to specifically look at racial and ethnic disparities in the field of neurosurgical trauma. This research has demonstrated significant inequities in the mortality of TBI patients based on race and ethnicity and indicates a substantive need to reshape the current healthcare system and advocate for safer and more supportive pre-hospital social systems to prevent these life-threatening sequelae.https://www.frontiersin.org/articles/10.3389/fsurg.2021.690971/fullmortalitydisparitiesinequitiesTBIneurotraumarace
spellingShingle Emma A. Richie
Joseph G. Nugent
Ahmed M. Raslan
Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action
Frontiers in Surgery
mortality
disparities
inequities
TBI
neurotrauma
race
title Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action
title_full Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action
title_fullStr Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action
title_full_unstemmed Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action
title_short Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action
title_sort racial and ethnic inequities in mortality during hospitalization for traumatic brain injury a call to action
topic mortality
disparities
inequities
TBI
neurotrauma
race
url https://www.frontiersin.org/articles/10.3389/fsurg.2021.690971/full
work_keys_str_mv AT emmaarichie racialandethnicinequitiesinmortalityduringhospitalizationfortraumaticbraininjuryacalltoaction
AT josephgnugent racialandethnicinequitiesinmortalityduringhospitalizationfortraumaticbraininjuryacalltoaction
AT ahmedmraslan racialandethnicinequitiesinmortalityduringhospitalizationfortraumaticbraininjuryacalltoaction