Racial Disparities in the Operative Management of Orthopedic Trauma: A Systematic Review and Meta-Analysis.

Autor:	Johnson CT; Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA., Tran A; Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA., Preslar J; Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA., Bussey-Jones J; Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA., Schenker ML; Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2023 Nov; Vol. 89 (11), pp. 4521-4530. Date of Electronic Publication: 2022 Aug 18.
DOI:	10.1177/00031348221121561
Abstrakt:	Objective: The objective of this study was to investigate if race is associated with the likelihood of operative management of acute fractures. Methods: A systematic review of the literature was performed using the PubMed, EMBASE, and Cochrane databases to identify studies associated with social disparities and acute orthopedic trauma. Peer-reviewed studies commenting on social disparities and the decision to pursue operative or non-operative management of acute fractures were identified for detailed review. Study characteristics and odds ratios were extracted from each article. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed. A quality analysis of the data was also performed. Results: In total, 13 studies were identified and 8 were included in the meta-analysis totaling 743,846 fractures. Hip, distal radius, pelvic, tibial plateau, clavicle, femoral neck, and femoral shaft fractures were represented in this patient population. The meta-analysis demonstrated that White race is associated with a higher likelihood of operative intervention compared to all other races pooled together (odds ratio, 1.31; 95% confidence interval 1.16 to 1.47; p < .0001) as well as Black race (odds ratio 1.39; 95% confidence interval 1.12 to 1.72; p = .0025). Conclusions: Non-White race and Black race are associated with a lower likelihood of receiving surgical management of acute orthopedic trauma. Surgeons and health systems should be aware of these inequities and consider strategies to mitigate bias and ensure all patients receive appropriate and timely care regardless of race. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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