ArticleAnnals of surgery2013
Minority trauma patients tend to cluster at trauma centers with worse-than-expected mortality: can this phenomenon help explain racial disparities in trauma outcomes?
Article in Annals of surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Disparities in Adult and Pediatric Trauma Outcomes: a Systematic Review and Meta-Analysis.World journal of surgery · 2020Pooled it
- Recruitment and enrollment of African Americans and Caucasians in a health promotion trial for persons with serious mental illness.Ethnicity & disease · 2015Trial
- Utilization of whole-body computed tomography in trauma: The role of trauma center level and ACS verification.Surgery open science · 2026Article
- Outcomes After Traumatic Brain Injury Surgery: Investigating Racial Disparities.Journal of racial and ethnic health disparities · 2026Article
- Screening for methamphetamine and amphetamine use in trauma: a public health opportunity.Health affairs scholar · 2026Article
- Center-Level Variation in the Development of Acute Kidney Injury Following Cardiac Operation.CJC open · 2025Article
- Understanding disparities in firearm mortality: The role of person- and place-based factors.Injury · 2025Article
- Racial and Ethnic Disparities in Use of Helicopter Transport After Severe Trauma in the US.JAMA surgery · 2025Article
- Disparities in Trauma Care for Latino Patients: An Analysis by Trauma Center Verification Level.Cureus · 2024Article
- Factors associated with racial and ethnic disparities in chronic pain after acute traumatic injury.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2024Article
- Development and validation of a pediatric model predicting trauma-related mortality.BMC pediatrics · 2023Article
- Use of hospitals in the New York City Metropolitan Region, by race: how separate? How equal in resources and quality?BMC health services research · 2022Article
- Health care disparity exists among those undergoing emergent hernia repairs in New York State.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Racial disparities in mortality after severe traumatic brain injury in childhood: mediators identified by Oaxaca-Blinder decomposition of trauma registry data.Injury epidemiology · 2021Article
- Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action.Frontiers in surgery · 2021Article
- Achieving ethnic equality in the Israel trauma healthcare system: the case of the elderly population.Israel journal of health policy research · 2019Article
- Penetrating Colon Trauma Outcomes in Black and White Males.American journal of preventive medicine · 2018Article
- Associations of Distance to Trauma Care, Community Income, and Neighborhood Median Age With Rates of Injury Mortality.JAMA surgery · 2018Article
- Inpatient Trauma Mortality after Implementation of the Affordable Care Act in Illinois.The western journal of emergency medicine · 2018Article
- Potential impact of Affordable Care Act-related insurance expansion on trauma care reimbursement.The journal of trauma and acute care surgery · 2017Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesTo determine whether minority trauma patients are more commonly treated at trauma centers (TCs) with worse observed-to-expected (O/E) survival.
backgroundRacial disparities in survival after traumatic injury have been described. However, the mechanisms that lead to these inequities are not well understood.
methodsAnalysis of level I/II TCs included in the National Trauma Data Bank 2007-2010. White, Black, and Hispanic patients 16 years or older sustaining blunt/penetrating injuries with an Injury Severity Score of 9 or more were included. TCs with 50% or more Hispanic or Black patients were classified as predominantly minority TCs. Multivariate logistic regression adjusting for several patient/injury characteristics was used to predict the expected number of deaths for each TC. O/E mortality ratios were then generated and used to rank individual TCs as low (O/E <1), intermediate, or high mortality (O/E >1).
resultsA total of 556,720 patients from 181 TCs were analyzed; 86 TCs (48%) were classified as low mortality, 6 (3%) intermediate, and 89 (49%) as high mortality. More of the predominantly minority TCs [(82% (22/27) vs 44% (67/154)] were classified as high mortality (P < 0.001). Approximately 64% of Black patients (55,673/87,575) were treated at high-mortality TCs compared with 54% Hispanics (32,677/60,761) and 41% Whites (165,494/408,384) (P < 0.001).
conclusionsMinority trauma patients are clustered at hospitals with significantly higher-than-expected mortality. Black and Hispanic patients treated at low-mortality hospitals have a significantly lower odds of death than similar patients treated at high-mortality hospitals. Differences in TC outcomes and quality of care may partially explain trauma outcomes disparities.
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