Demographic differences in systemic inflammatory response syndrome score after trauma.
BACKGROUND
Demographic differences in health outcomes have been reported for chronic diseases, but few data exist on these differences in trauma (defined as acute, life-threatening injuries).


OBJECTIVE
To investigate the relationship between the systemic inflammatory response syndrome score after trauma and race/ethnicity and socioeconomic status.


METHODS
A retrospective chart review of 600 patients from a level I trauma center (1997-2007) was conducted. Inclusion criteria were age 18 to 44 years, Injury Severity Score 15 or greater, and admission to an intensive care unit. Exclusion criteria were use of transfusions, spinal cord injuries, comorbid conditions affecting the inflammatory response, use of nonsteroidal anti-inflammatory medications, and missing data (final sample, 246 charts/patients). Systemic inflammatory response syndrome was measured by using the systemic inflammatory response syndrome score. Race was self-reported. Socioeconomic status was defined by insurance and employment. Descriptive statistics, Wilcoxon rank sum, Kruskal-Wallis, and χ(2) tests were used for analysis.


RESULTS
Compared with whites, African Americans (n = 94) had fewer occurrences of the syndrome (P = .04) and a 14% lower white blood cell count on admission to the intensive care unit (mean, 15,200/μL; 95% CI, 14,400/μL to 16,000/μL vs mean 17,700/μL; 95% CI, 16,700/μL to 18,700/μL; P < .001).


CONCLUSIONS
Demographic differences exist in the systemic inflammatory response syndrome score after trauma. Additional studies in larger populations of patients are needed as well as basic science and translational research to determine potential mechanisms that may explain the differences.
Department of Physiological and Technological Nursing, College of Nursing, Georgia Health Sciences University, Augusta, 30912, USA. bnesmith@georgiahealth.edu
Elizabeth G
EG
NeSmith
Sally P
SP
Weinrich
Jeannette O
JO
Andrews
Regina S
RS
Medeiros
Michael L
ML
Hawkins
Martin C
MC
Weinrich
D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007362:Intensive Care Units; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications* / Q000208:ethnology; D055815:Young Adult