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美国各地急诊室就诊成年人的脑震荡诊断和损伤机制中的种族差异。

Racial differences in concussion diagnosis and mechanism of injury among adults presenting to emergency departments across the United States.

机构信息

Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA.

Department of Community Medicine, School of Medicine, Mercer University, Columbus, Georgia.

出版信息

Brain Inj. 2023 Dec 6;37(12-14):1326-1333. doi: 10.1080/02699052.2023.2248581. Epub 2023 Aug 21.

Abstract

OBJECTIVES

The purpose of this study was to examine the association between race and concussion diagnosis as well as the association between race and mechanism of injury (MOI) for concussion diagnoses in adult patients (>19 years old) visiting the emergency department (ED).

METHODS

A retrospective analysis of patient visits to the ED for concussion between 2010 and 2018, using the National Hospital Ambulatory Medical Care Survey, was conducted. Outcome measures included concussion diagnosis and MOI. Multivariable and multinomial logistic regression analyses were conducted to assess associations between race and outcome variables. The results were weighted to reflect population estimates with a significance set at  < 0.05.

RESULTS

Overall, 714 patient visits for concussions were identified, representing an estimated 4.3 million visits nationwide. Black adults had lower odds of receiving a concussion diagnosis [ < 0.05, Odds Ratio (OR), 0.54; 95% Confidence Interval (CI), 0.38-0.76] compared to White adults in the ED. There were no significant differences in MOI for a concussion diagnosis by race.

CONCLUSION

Racial differences were found in the ED for concussion diagnosis. Disparities in concussion diagnosis for Black or other minoritized racial groups could have significant repercussions that may prolong recovery or lead to long-term morbidity.

摘要

目的

本研究旨在探讨种族与急诊就诊成人患者(>19 岁)脑震荡诊断之间的关系,以及种族与脑震荡损伤机制(MOI)之间的关系。

方法

采用 2010 年至 2018 年国家医院门诊医疗调查的回顾性分析,对因脑震荡到急诊就诊的患者进行研究。主要结局指标包括脑震荡诊断和 MOI。采用多变量和多项逻辑回归分析评估种族与结局变量之间的关联。结果经过加权处理,以反映人口估计值,显著性水平设为<0.05。

结果

总体而言,共确定了 714 例因脑震荡就诊的患者,代表了全国范围内估计有 430 万次就诊。与白人成年人相比,黑人成年人在急诊就诊时脑震荡诊断的可能性较低[<0.05,优势比(OR)为 0.54;95%置信区间(CI)为 0.38-0.76]。不同种族间脑震荡诊断的 MOI 无显著差异。

结论

在急诊就诊时发现了脑震荡诊断的种族差异。黑人或其他少数族裔群体的脑震荡诊断差异可能会产生重大影响,这可能会延长康复时间或导致长期发病。

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