Introduction: Racial and ethnic disparities exist across outcomes for a variety of conditions in the United States but have been less vigorously explored amongst pediatric populations and certainly amongst those suffering from traumatic brain injuries. We sought the rates of in hospital mortality for pediatric patients admitted with traumatic brain injuries from a statewide database of all civilian hospital discharges.
Methods: The Texas Inpatient Public Use Data File is the second largest state level data set of hospital discharges in the United States. This database was queried for all hospital discharges related to an admission diagnosis of traumatic brain injury by ICD-9 code between 2006 and 2011. The ICD-9 codes queried appear in table 1. This query was then weaned to those patients less than 18 years of age. The combined classification of race and ethnicity, as defined in the Texas Inpatient Public Use Data File included: Native American, Asian, Black, Hispanic, Non-Hispanic White, Other. All non-white admissions were classified as minorities. These admission were then queried for disposition at discharge.
Results: Non-hispanic white children had a significantly lower rate of in hospital mortality than blacks (3.3% versus 5.0%, p=0.003) and minorities as a whole (3.3% versus 4.2%, p=0.009). These differences persisted even when using logistic regression to control for insurance status, insurance type and illness severity.
Conclusions: Racial and ethnic minority children in the state of Texas have higher in in hospital mortality and are less likely to be discharged to inpatient rehabilitation following traumatic brain injury. The significance of minority status persists even when controlling for some insurance factors and illness severity.
Patient Care: This study demonstrates ethnic and racial disparities in pediatric traumatic brain injury not previously published and may prompt investigation of the etiology for such disparity and strategies to mitigate such
Learning Objectives: By the conclusion of this session, participants should be able to understand persistent racial and ethnic disparities in the rates of traumatic brain injury and the short term outcomes