title: The Hispanic paradox: does it exist in the injured?
abstract: BACKGROUND
  Hispanics have similar or lower all-cause mortality rates in the general population than non-Hispanic whites (NHWs), despite higher risks associated with lower socioeconomic status, hence termed the "Hispanic Paradox." It is unknown if this paradox exists in the injured. We hypothesized that Hispanic trauma patients have equivalent or lower risk-adjusted mortality and observed-to-expected mortality ratios than other racial/ethnic groups.
  
  
  METHODS
  Retrospective analysis of adult patients from the 2010 National Trauma Data Bank was performed. Hispanic patients were compared with NHWs and African Americans (AAs) to assess in-hospital mortality risk in each group.
  
  
  RESULTS
  Compared with NHWs, Hispanic patients had lower unadjusted risk of mortality. After adjusting for potential confounders, the difference was no longer statistically significant. Mortality risk was significantly lower for Hispanic patients compared with AAs in both crude and adjusted models. Hispanic patients had significantly lower observed-to-expected mortality ratios than NHWs and AAs.
  
  
  CONCLUSIONS
  Despite reports of racial/ethnic disparities in trauma outcomes, Hispanic patients are not at greater risk of death than NHW patients in a nationwide representative sample of trauma patients.
authors: Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA. Electronic address: toverton@jpshealth.org.
authors: Tiffany L
authors: TL
authors: Overton
authors: Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors: J Laureano
authors: JL
authors: Phillips
authors: Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors: Billy J
authors: BJ
authors: Moore
authors: Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors: Mackenzie B
authors: MB
authors: Campbell-Furtick
authors: Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors: Rajesh R
authors: RR
authors: Gandhi
authors: Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors: Shahid
authors: S
authors: Shafi
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D016208:Databases, Factual; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000401:mortality*; D001741:Black or African American
keywords: Hispanic paradox; Mortality; Racial/ethnic disparities; Trauma