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德克萨斯州创伤性脑损伤后少数族裔儿科患者的短期预后

Short-Term Outcomes of Ethnic and Racial Minority Pediatric Patients Following Traumatic Brain Injury in the State of Texas.

作者信息

Son Colin, Tarasiewicz Izabela

机构信息

Neurosurgery, Neurosurgical Associates of San Antonio, San Antonio, USA.

Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, USA.

出版信息

Cureus. 2021 Jun 30;13(6):e16050. doi: 10.7759/cureus.16050. eCollection 2021 Jun.

Abstract

Background Pediatric traumatic brain injury represents a significant cause of morbidity and mortality. Broadly healthcare disparities exist for ethnic and racial minorities in the United States but it has not previously be evaluated how these disparities might influence outcomes in pediatric traumatic brain injury. Methods We sought all hospital admissions between the years 2006 and 2011 for patients aged 0-17 years admitted with traumatic brain injuries as identified by the International Classification of Diseases, 9th Revision (ICD-9) code, from a statewide database of all civilian hospital admissions. Demographic information including race, ethnicity, insurance status and illness severity as calculated by All Patient Refined-Diagnosis Related Group (APR-DRG) were analysed versus the disposition at discharge. Results 14,087 pediatric traumatic brain injury patients were admitted between 2006 and 2011. Pediatric traumatic brain injury patients of ethnic or racial minority had higher rates of in-hospital mortality as compared to whites (4.2% versus 3.3%, p = 0.009) and were less likely to be discharged to inpatient rehabilitation (2.9% versus 4%, p < 0.001). These disparities persisted even when controlling for insurance status and illness severity. Conclusion Ethnic and racial minority children from the U.S. state of Texas suffer worse short-term outcomes following traumatic brain injury than their white counterparts. Strategies are needed for addressing this disparity.

摘要

背景

小儿创伤性脑损伤是发病和死亡的重要原因。在美国,少数族裔在医疗保健方面普遍存在差异,但此前尚未评估这些差异如何影响小儿创伤性脑损伤的治疗结果。方法:我们从一个全州所有平民医院入院患者的数据库中,查找2006年至2011年间因创伤性脑损伤入院的0至17岁患者,这些患者的诊断依据国际疾病分类第九版(ICD - 9)编码确定。分析了包括种族、族裔、保险状况以及通过全患者精细诊断相关组(APR - DRG)计算得出的疾病严重程度等人口统计学信息与出院时的处置情况之间的关系。结果:2006年至2011年间,共收治了14,087例小儿创伤性脑损伤患者。与白人相比,少数族裔的小儿创伤性脑损伤患者院内死亡率更高(4.2%对3.3%,p = 0.009),且出院后进入住院康复的可能性更小(2.9%对4%,p < 0.001)。即使在控制了保险状况和疾病严重程度后,这些差异仍然存在。结论:美国得克萨斯州的少数族裔儿童在创伤性脑损伤后短期治疗结果比白人儿童更差。需要制定策略来解决这一差异。

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