Mortality Up in Hospitals With More Minority Trauma Patients, ages 18-64 years

Trauma patients’ odds of mortality linked to the proportion of minority patients in the hospital

The odds of in-hospital mortality for trauma patients are associated with the proportion of minority patients in the hospital, according to a study published online in the Archives of Surgery.

Adil H. Haider, M.D., M.P.H., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues investigated whether the odds of mortality increased among trauma patients in hospitals with high proportions of minorities.

The adjusted odds ratio for in-hospital and crude mortality for 311,568 patients (white, black, or Hispanic), aged 18 to 64 years, with an injury severity score of nine or more, were analyzed after adjusting for multiple patient and injury severity characteristics.

A comparison was made between hospitals with less than 25 percent of the patients coming from minority groups (reference group) and those with 25 to 50 percent or more than 50 percent of patients from minority groups.

The investigators found that, in the hospitals where more than 50 percent of the patients were from minority groups, patients tended to be younger, less likely to be female, had more penetrating trauma, and had the highest crude mortality.

After adjusting for potential confounders, patients from hospitals with 25 to 50 percent minority patients or with more than 50 percent minority patients had increased odds of death compared to the reference group (adjusted odds ratio, 1.16 and 1.37, respectively). Subset analysis of patients with blunt injury revealed an increased disparity between hospitals.

“Patients treated at hospitals with higher proportions of minority trauma patients have increased odds of dying, even after adjusting for potential confounders,” the authors write.

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