Abstract Details

Title Variations in Cause of Injury May Explain Disparities in In-Hospital Mortality after TBI

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P11 - Poster Session 11 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-012

Objective Determine if mechanism of injury can explain race-ethnic disparities in post-traumatic brain injury (TBI) mortality.

Background Race-ethnic differences in post-TBI mortality are not fully explained by severity or insurance status alone.

Design/Methods Retrospective cohort analysis of 3,740 adult TBI cases in the South Florida area from 2008-2013. Demographic differences were evaluated via Students t-test, Pearson's chi-squared, and logistic regression to assess association with post-TBI mortality.

Results

1,069 White, 810 Black, 1,843 Hispanic, and 18 Other patients were stratified by race-ethnic group. When compared to Whites, Black patients were younger (p<0.001) and more likely to be male (p<0.001). Univariate analysis found increased mortality for Uninsured (OR 1.52, 95% CI: 1.08-2.14) and Medicare (2.64, 1.88-3.69) patients, when compared to Medicaid. TBI resulting from violence resulted in higher odds of mortality (1.40, 1.07-1.83) than TBI due to vehicular injury.

Multivariate analysis revealed that Black males had decreased likelihood of mortality when compared to Black females (0.37, 0.16-0.86), while neither White nor Hispanic populations experienced a sex difference in mortality. Insured Blacks (0.20, 0.08-0.48) and Hispanics (0.56, 0.34-0.94) experienced lower odds of death than their uninsured counterparts while Whites did not. Odds of TBI caused by a weapon or violence in Black females was comparable to Black males and much higher than in White Females (7.27, 3.0-17.6).

Conclusions Differences in cause of TBI contributed to race-ethnic variation in post-TBI mortality due to increased odds of violent-type TBI in Black patients. While it is logical that patients who suffer TBI due to a weapon/violence are more likely to die than people whose TBI was of vehicular origin, the unexpected finding was that Black women experience far more weapon/violence-type TBIs than women of other races and with odds on par with Black men. Future work should aim to study the factors contributing to sex and race-ethnic disparities in TBI causes.

Authors/Disclosures
Sai P. Polineni, MD PRESENTER	Dr. Polineni has nothing to disclose.
Enmanuel Perez, MD, PhD (Department of Neurology, Washington University School of Medicine in St. Louis)	Dr. Perez has nothing to disclose.
	No disclosure on file
Christopher Chin, MD (FrontPoint Healthcare)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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Abstract Details