Evidence map›Paper›PMID 40377892›Full record

ArticleJournal of racial and ethnic health disparities2026

Racial and Ethnic Differences in Withdrawal of Life-Sustaining Treatment and Hospice Referral in Severe Traumatic Brain Injury.

Erin Hennessey, Tamriage Martin, Beth Turrentine, Michelle Pomphrey, Justin Richards, Lliam B Brannigan, Emily Schneiderman, Bhiken Naik, Michael Mazzeffi

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Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Erin HennesseyDepartment of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Tamriage MartinDepartment of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
Beth TurrentineDepartment of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
Michelle PomphreyDepartment of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
Justin RichardsDepartment of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.
Lliam B BranniganDepartment of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Emily SchneidermanDepartment of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Bhiken NaikDepartment of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Michael MazzeffiDepartment of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA. syy4wa@uvahealth.org.ORCID 0000-0003-2955-4915

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with severe traumatic brain injury (TBI) frequently require surrogate decision-making including decisions about end-of-life care. Because prognostication in severe TBI remains challenging, there may be significant variation in surrogate decision-making. Our study aim was to explore differences in withdrawal of life-sustaining treatment (WLST) and hospice referral among patients of different races and ethnicities who had severe TBI.

methodsA retrospective cohort study was performed using the Trauma Quality Programs Participant Use File from 2022. Patients with severe TBI were identified using diagnostic codes. Severe TBI was defined as Glasgow Coma Scale ≤ 8 at hospital admission. The study's primary outcomes were WLST and referral to hospice. Multivariable logistic regression models were fit to explore risk-adjusted associations between race and ethnicity, and WLST and hospice referral.

resultsThere were 4121 patients included in the final study cohort. Among these, 57.4% were non-Hispanic White, 17.3% were non-Hispanic Black, 14.3% were Hispanic, and 11.0% were non-Hispanic patients of other races. Race and ethnicity were independently associated with WLST. Non-Hispanic Black patients had lower risk-adjusted odds of WLST compared to non-Hispanic White patients; OR = 0.49 (95% CI = 0.37 to 0.65, p < .001). Hispanic patients and non-Hispanic patients of other races also had lower risk-adjusted odds of WLST; OR = 0.59 (95% CI = 0.44 to 0.78, p < .001) and OR = 0.67 (95% CI = 0.49 to 0.90, p = .009). Non-Hispanic Black patients had lower risk-adjusted odds of hospice referral; OR = 0.42 (95% CI = 0.20 to 0.88, p = .02) compared to non-Hispanic White patients.

conclusionsPatients of different races and ethnicities with severe TBI have different rates of WLST and hospice referral. Additional research is needed to better understand the reasons for differences in surrogate decision-making and WLST including the potential influence of culture, religion, socioeconomic status, and medical literacy.

Indexed as

Brain Injuries, TraumaticEthnicityHealthcare DisparitiesHospice CareRacial GroupsReferral and ConsultationWithholding TreatmentAdultAgedBlack or African AmericanFemaleHispanic or LatinoHumansMaleMiddle AgedRetrospective StudiesBrain injuryDisparitiesEnd-of-life careHospiceTrauma

Identifiers

PMID40377892
PMCPMC13346166

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