Despite overall low pediatric head injury mortality, disparities exist between races
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Published on: February 7, 2025
Richard A Falcone1, Colin Martin, Rebeccah L Brown
1Division of Pediatric and Thoracic Surgery, Department of Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229-3039, USA. richard.falcone@cchmc.org
Insights
This study found that while overall outcomes for pediatric head injuries are good, African American children face higher mortality rates compared to white children. Further investigation into these racial disparities in head injury care is crucial.
Area of Science:
- Pediatric Traumatology
- Public Health
- Health Equity
Background:
- Evaluating outcomes in pediatric head injury care is essential for quality improvement.
- Assessing outcomes across diverse patient groups is critical for identifying disparities.
Purpose of the Study:
- To compare overall and race-specific mortality rates in children with head injuries.
- To investigate potential racial disparities in head injury outcomes using local and national data.
Main Methods:
- Data were extracted from the National Trauma Data Bank and a local trauma registry.
- Unadjusted and adjusted analyses, including logistic regression, were performed to assess mortality.
- Stratified analysis was used to examine race-specific outcomes.
Main Results:
- A total of 16,474 children with head injuries were analyzed (13,363 national, 3111 local).
- Local mortality rates (3.2%) were lower than national rates (6.8%).
- African American children experienced significantly higher mortality (5.3%) than white children (2.2%) in local data, with race identified as an independent predictor (OR 3.1).
Conclusions:
- Despite favorable overall outcomes, significant racial disparities in mortality exist for pediatric head injuries.
- African American children face a higher risk of mortality following head injury.
- These findings underscore the necessity of subgroup analysis to uncover and address health inequities.
Background:
To continually improve quality of care, it is important for centers caring for children with head injury to evaluate their overall outcome and that among diverse patient groups.
Methods:
Data on children with head injuries were extracted from the National Trauma Data Bank of the American College of Surgeons and our local trauma registry. Unadjusted mortality, as well as stratified analysis and logistic regression modeling, was used to evaluate overall and race-specific mortality.
Results:
There were 13,363 children in the National Trauma Data Base and 3111 in our database included. Our overall mortality rate compared favorably with the national data (3.2% vs 6.8%, P < .05). Our local data, however, showed a significant difference in mortality between white and African American (AA) children (2.2% vs 5.3%, P < .05), which was not identified in the national data. After stratification, the disparities by race persisted. Finally, multivariate regression modeling revealed that AA race was an independent predictor of mortality among our patient population, with an odds ratio of 3.1 (95% confidence interval, 1.2-7.8).
Conclusion:
Despite excellent outcomes for children with head injuries, we have uncovered unsettling inequities between AA and white children. These findings support the need to evaluate outcomes among specific groups to identify disparities that require further careful investigation.
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