Racial disparities and the acute management of severe blunt traumatic brain injury
| Autor: | Rohit Sharma, Jonathan Grotts, Jing Li, Zach M. DeBoard, Arianne Johnson, Isabella Zikakis, Stephen Kaminski |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Traumatic brain injury Poison control Critical Care and Intensive Care Medicine law.invention outcomes research 03 medical and health sciences 0302 clinical medicine Blunt brain injuries law Medicine Racial disparities neurosurgery 030212 general & internal medicine Abbreviated Injury Scale business.industry Mortality rate Glasgow Coma Scale medicine.disease Intensive care unit 030220 oncology & carcinogenesis Emergency medicine Original Article Surgery Outcomes research business |
| Zdroj: | Trauma Surgery & Acute Care Open |
| ISSN: | 2397-5776 |
| DOI: | 10.1136/tsaco-2019-000358 |
| Popis: | BackgroundTraumatic brain injury (TBI) is a significant source of morbidity and mortality. In patients with TBI, racial disparities have been shown to exist in patient outcomes. Identifying where disparities occur along the patient continuum of care will allow for targeted interventions. This study evaluated if racial disparity exists for neuromonitoring and neurointervention rates in patients with severe TBI due to blunt injury.MethodsThe National Trauma Data Bank was used to identify patients aged 18 to 55 years old from 2007 through 2016 with a blunt injury, an initial Glasgow Coma Scale score of 3 to 8, a head Abbreviated Injury Scale score of 3 to 5, and all other anatomic Abbreviated Injury Scale scores less than 3. Coarsened exact matching (CEM) was used to balance covariates between white and non-white patients. Rates of neuromonitoring and neurosurgical interventions were compared between groups. Secondary outcomes were days spent in the intensive care unit (ICU), total hospital length of stay (LOS), and mortality.ResultsA total of 3692 patients with severe isolated TBI due to blunt injury were identified. After applying CEM, 1064 patients were analyzed (644 white, 420 non-white). No differences were observed between white and non-white patient groups for neuromonitoring, neurointervention, mortality, or ICU LOS. White patients had a shorter hospital LOS (8 days vs. 9 days, pDiscussionFor severe isolated blunt TBI, neuromonitoring, neurointervention, and mortality rates were similar for white and non-white patients. Although racial disparities in patient outcomes exist, these differences do not seem to be due to neuromonitoring and neurointervention rates for management of TBI.Level of evidenceLevel III. |
| Databáze: | OpenAIRE |
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