Racial disparities in outcomes of persons with moderate to severe traumatic brain injury.
BACKGROUND
Although racial differences in hospital outcomes are well known for medical conditions (eg, cardiovascular disease), it is unknown whether differences exist for patients with traumatic brain injury (TBI).


METHODS
Using the National Trauma Data Bank, we examined racial and ethnic differences in hospital outcomes of 56,482 patients with moderate to severe TBI who were hospitalized in level I or II trauma-designated hospitals between 2000 and 2003. We examined racial and ethnic disparities in in-hospital mortality and the likelihood of survivors receiving postacute care at a rehabilitation center.


RESULTS
After multivariable adjustment, compared with whites, we observed increased in-hospital mortality for blacks (odds ratio [OR] = 1.19, P = 0.026) and Asians (OR = 1.41, P = 0.005). We observed a trend toward significance for Hispanics (OR = 1.41, P = 0.077), but not for other races. For survivors, compared with whites, blacks and Hispanics were less likely to be discharged to a rehabilitation center (OR = 0.68, P < 0.001, and OR = 0.67, P = 0.002, respectively).


CONCLUSIONS
Racial and ethnic disparities exist both in mortality and in discharge to postacute rehabilitation centers among persons with TBI.
Bowman
Stephen M
SM
Department of Health Services, University of Washington, Seattle, WA, USA. bowmanstephenm@uams.edu
Martin
Diane P
DP
Sharar
Sam R
SR
Zimmerman
Frederick J
FJ
D000328:Adult; D001930:Brain Injuries / Q000208:ethnology* / Q000401:mortality / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D016896:Treatment Outcome