Differences in Pediatric Unintentional Injury Outcomes by Race/Ethnicity
Chung, Choyin Yvonne
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Unintentional injuries contribute significantly to childhood mortality and morbidity nationally and globally. In the United States, they are the leading cause of death in children over the age of 1, causing more than 9,000 childhood deaths each year. Moreover, for every fatality, there are over 1,000 children seeking medical care for nonfatal unintentional injuries. The staggering rates of both fatal and nonfatal injuries impose a tremendous strain on individual families, the medical system, and the national economy. Risk factors that predict poor outcome in pediatric unintentional injuries have been identified; they include, most notably, lack of insurance and minority race/ethnicity. However, more recently studies conducted in racially diverse settings have not found a similar association between minority race/ethnicity and poor outcome. This study utilizes trauma data from January 1996 to December 2012 from the University of Texas Medical Branch in Galveston, Texas to compare outcomes of pediatric unintentional injury between patients of White, Black, and Hispanic race/ethnicity. By adjusting for age, sex, insurance status, and severity of injury, we aim to assess whether minority race/ethnicity is a predictor of poor outcomes. The primary outcome is mortality; secondary outcomes are injury severity, the need for emergent surgery, hospital length of stay, and residual morbidity after hospital discharge. After adjustments, Hispanic ethnicity is found not to be associated with increased risk of mortality when compared to White patients. This is in contrast with Black patients, who are found to be at increased risk. Additionally, insurance status patterns differ by race/ethnicity and appear to confer various degrees of protection against mortality.