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Artigo em Inglês | MEDLINE | ID: mdl-26455290

RESUMO

OBJECTIVE: A retrospective cross-sectional analysis was undertaken to determine the impact of race and insurance status on trauma outcomes in patients admitted to a Level I trauma center following head and neck fractures. STUDY DESIGN: Putative predictive factors, including injury mechanism, hemorrhagic shock, injury severity score (ISS), race, gender, and insurance status, were used in a multivariate outcome analysis to determine their influence on length of hospital stay, number of procedures performed, discharge status, and mortality; P < .05 was significant. RESULTS: Proportionately more male patients (76.5%) sustained head and neck fractures compared with females (23.5%). Blacks and Hispanics sustained proportionately more gunshot wounds (GSWs) compared with Whites, 16:1 and 7:1, respectively. There were no significant differences in length of hospital stay and mortality based on race or insurance status. Mortality was related to age, GSW as a mechanism of injury, increasing ISS, and shock on admission. CONCLUSIONS: Minority race and insurance status did not correlate with worse outcomes. Treatment biases in the acutely injured patient with head and neck injuries may be less prevalent than thought, if we consider mortality and utilization of care as primary outcome measures.


Assuntos
Vértebras Cervicais/lesões , Disparidades em Assistência à Saúde , Hospitalização , Fraturas Cranianas/etnologia , Fraturas Cranianas/mortalidade , Fraturas da Coluna Vertebral/etnologia , Fraturas da Coluna Vertebral/mortalidade , Adulto , Boston/epidemiologia , Estudos Transversais , Feminino , Humanos , Escala de Gravidade do Ferimento , Cobertura do Seguro , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Choque Hemorrágico/etnologia , Choque Hemorrágico/mortalidade , Centros de Traumatologia , Resultado do Tratamento
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