Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Maine Medical Center, Portland, ME 04101, USA.
Am J Epidemiol. 2013 Mar 1;177(5):380-7. doi: 10.1093/aje/kws242. Epub 2013 Jan 30.
Prior studies on racial and ethnic disparities in survival after motor vehicle crashes have examined only population-based death rates or have been restricted to hospitalized patients. In the current study, we examined 3 components of crash survival by race/ethnicity: survival overall, survival to reach a hospital, and survival among those hospitalized. Nine years of data (from 2000 through 2008) from the National Automotive Sampling System Crashworthiness Data System were used to examine white non-Hispanic, black non-Hispanic, and Hispanic drivers aged ≥ 15 years with serious injuries (injury severity scores of ≥ 9). By using multivariable logistic regression, we found that a driver's race/ethnicity was not significantly associated with overall survival after being injured in a crash (for blacks, odds ratio (OR) = 0.69, 95% confidence interval (CI): 0.36, 1.32; for Hispanics, OR = 1.00, 95% CI: 0.59, 1.72), and blacks and Hispanics were equally likely to survive to be treated at a hospital compared with whites (for blacks, OR = 1.00, 95% CI: 0.52, 1.93; for Hispanics, OR = 1.13, 95% CI: 0.71, 1.79). However, among patients who were treated at a hospital, blacks were 50% less likely to survive 30 days compared with whites (OR = 0.50, 95% CI: 0.33, 0.76). The disparity in survival after serious traffic injuries among blacks appears to occur after hospitalization, not in prehospital survival.
先前关于机动车事故后生存的种族和民族差异的研究仅检查了基于人群的死亡率,或者仅限于住院患者。在当前的研究中,我们通过种族/族裔检查了碰撞生存的 3 个组成部分:总体生存,到达医院的生存以及住院患者的生存。使用国家汽车抽样系统碰撞性能数据系统的 9 年数据(2000 年至 2008 年),检查了年龄≥15 岁,受伤严重(伤害严重程度评分≥9)的白种非西班牙裔,黑种非西班牙裔和西班牙裔驾驶员。通过使用多变量逻辑回归,我们发现驾驶员的种族/民族与碰撞受伤后的总体生存没有明显关联(对于黑人,优势比(OR)= 0.69,95%置信区间(CI):0.36,1.32;对于西班牙裔,OR = 1.00,95%CI:0.59,1.72),与白人相比,黑人或西班牙裔患者同样有可能存活到医院接受治疗(对于黑人,OR = 1.00,95%CI:0.52,1.93;对于西班牙裔,OR = 1.13,95%CI:0.71,1.79)。但是,在接受医院治疗的患者中,黑人在 30 天内的存活率比白人低 50%(OR = 0.50,95%CI:0.33,0.76)。黑人在严重交通事故伤害后的生存差异似乎发生在住院后,而不是在院前生存中。