Adil H. Haider
Association Between Hospitals Caring for a Disproportionately High Percentage of Minority Trauma Patients and Increased Mortality
Cedars-Sinai Medical Center
determine whether increased odds mortality among trauma patients treated hospitals higher proportions minority patients ie black hispanic patients combinedhospitals categorized basis percentage minority patients admitted trauma adjusted odds inhospital mortality compared hospitals less 25 patients minorities reference group hospitals 25 50 patients minorities hospitals 50 patients minorities multivariate logistic regression generalized linear modeling clustercorrelated robust estimate variance used control multiple patient injury severity characteristicsa total 434 hospitals national trauma data bankpatients aged 18 64 years whose medical records included national trauma data bank years 2007 2008 injury severity score 9 greater white black hispaniccrude mortality adjusted odds inhospital mortalitya total 311568 patients examined hospitals percentage minority patients 50 also younger patients fewer female patients patients penetrating trauma highest crude mortality adjustment potential confounders patients treated hospitals percentage minority patients 25 50 hospitals percentage minority patients 50 demonstrated increased odds death adjusted odds ratio 116 95 confidence interval 101134 adjusted odds ratio 137 95 confidence interval 116161 respectively compared reference group disparity increased subset analysis patients blunt injury uninsured patients significantly increased odds mortality within 3 hospital groupspatients treated hospitals higher proportions minority trauma patients increased odds dying even adjusting potential confounders differences outcomes trauma hospitals may partly explain racial disparities