Counting the Lives Lost: How many black trauma deaths are attributable to disparities

Authors

Valerie K. Scott, The Johns Hopkins School of Medicine, Baltimore, MD
Zain G. Hashmi, The Johns Hopkins School of Medicine, Baltimore, MD
Eric B. Schneider, The Johns Hopkins School of Medicine, Baltimore, MD
Xuan Hui, The Johns Hopkins School of Medicine, Baltimore, MD
David T. Efron, The Johns Hopkins School of Medicine, Baltimore, MD
Edward E. Cornwell, Howard University College of Medicine, Washington, D.C
Adil H. Haider, The Johns Hopkins School of Medicine, Baltimore, MDFollow

Document Type

Article

Department

General Surgery

Abstract

Background: The number of black trauma deaths attributable to racial disparities is unknown. The objective of this study is to quantify the excess mortality suffered by black patients given disparities in the risk of mortality.
Materials and Methods: A retrospective analysis of patients aged 16–65 years with blunt and penetrating injuries included in the National Trauma Data Bank (NTDB) from 2007–2010 was performed. Generalized linear modeling estimated the relative risk of death for black patients versus white patients, adjusting for known confounders. This analysis determined the difference in the observed number of black trauma deaths at Level I and II centers and the expected number of deaths if the risk of mortality for black patients had been equivalent to that of white patients.
Result: 1.06 million patients were included. Among patients with blunt and penetrating injuries at Level I trauma centers, white males and females had a relative risk of death of 0.82 (95% CI 0.80, 0.85) and 0.78 (95% CI 0.74, 0.83), respectively, compared with black patients. Similarly, at Level II trauma centers white males and females had a relative risk of death of 0.84 (95% CI 0.80, 0.88) and 0.82 (95% CI 0.73, 0.91). Overall, of the estimated 41,613 deaths that occurred at Level I and II centers, 2,206 deaths (5.3%) were excess deaths among black patients.
Conclusion: Over a four year period, approximately five percent of trauma center deaths could be attributed to racial disparities in trauma outcomes. These data underscore the need to better understand and intervene against the mechanisms that lead to trauma outcomes disparities.

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

The Journal of surgical research

Recommended Citation

Scott, V. K., Hashmi, Z. G., Schneider, E. B., Hui, X., Efron, D. T., Cornwell, E. E., Haider, A. H. (2018). Counting the Lives Lost: How many black trauma deaths are attributable to disparities. The Journal of surgical research, 480(487), 184-1.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_gen/235