Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia, USA.
Department of Neurosurgery, Baylor Scott and White Health and Texas A&M University College of Medicine, Temple, Texas, USA.
J Neurotrauma. 2023 Mar;40(5-6):502-513. doi: 10.1089/neu.2021.0455. Epub 2022 Sep 29.
Traumatic brain injury (TBI) is a major cause of death and disability in the United States, exacting a debilitating physical, social, and financial strain. Therefore, it is crucial to examine the impact of TBI on medically underserved communities in the U.S. The purpose of the current study was to review the literature on TBI for evidence of racial/ethnic differences in the U.S. Results of the review showed significant racial/ethnic disparities in TBI outcome and several notable differences in other TBI variables. American Indian/Alaska Natives have the highest rate and number of TBI-related deaths compared with all other racial/ethnic groups; Blacks/African Americans are significantly more likely to incur a TBI from violence when compared with Non-Hispanic Whites; and minorities are significantly more likely to have worse functional outcome compared with Non-Hispanic Whites, particularly among measures of community integration. We were unable to identify any studies that looked directly at underlying racial/ethnic biological variations associated with different TBI outcomes. In the absence of studies on racial/ethnic differences in TBI pathobiology, taking an indirect approach, we looked for studies examining racial/ethnic differences in oxidative stress and inflammation outside the scope of TBI as they are known to heavily influence TBI pathobiology. The literature indicates that Blacks/African Americans have greater inflammation and oxidative stress compared with Non-Hispanic Whites. We propose that future studies investigate the possibility of racial/ethnic differences in inflammation and oxidative stress within the context of TBI to determine whether there is any relationship or impact on TBI outcome.
创伤性脑损伤 (TBI) 是美国死亡和残疾的主要原因，给身体、社会和经济带来了严重的负担。因此，研究 TBI 对美国医疗服务不足社区的影响至关重要。本研究的目的是回顾 TBI 相关文献，以评估美国 TBI 结果是否存在种族/民族差异。研究结果表明，TBI 结果存在显著的种族/民族差异，其他 TBI 变量也存在一些显著差异。与所有其他种族/民族群体相比，美洲印第安人/阿拉斯加原住民的 TBI 相关死亡率和人数最高；与非西班牙裔白人相比，黑人/非裔美国人因暴力而发生 TBI 的可能性显著更高；与非西班牙裔白人相比，少数族裔的功能结局更差，尤其是在社区融入方面。我们无法找到任何直接研究与不同 TBI 结果相关的种族/民族生物学差异的研究。由于没有关于 TBI 病理生物学中种族/民族差异的研究，我们采用间接方法，寻找研究氧化应激和炎症在 TBI 范围之外的种族/民族差异的研究，因为它们已知会严重影响 TBI 病理生物学。文献表明，与非西班牙裔白人相比，黑人/非裔美国人的炎症和氧化应激更大。我们提出，未来的研究应调查 TBI 背景下炎症和氧化应激的种族/民族差异的可能性，以确定是否存在任何关系或对 TBI 结果的影响。
