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A multicenter study of trauma center undertriage: Do racial disparities exist and do they impact outcomes?
Abdul Tawab Saljuqi1, Harun Mazumder2, Alessandro Orlando2
1University of Arizona, Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, Department of Surgery, College of Medicine, PO Box 245063, Tucson, Arizona, 85724, United States.
Introduction:
Little research exists on whether racial disparities impact trauma activation (TA). This study aimed to compare undertriage (UT) in Black vs. White patients.
Methods:
Black and White patients receiving high-intensity time-sensitive interventions (HITS) were selected from trauma registry data, 2017-19. UT was defined as patients receiving HITS without a highest-level TA. Mixed-effects multivariable regressions compared odds of UT and outcomes by race groups.
Results:
4734 Black and 11,070 White patients at 37 Level I/II centers had HITS. UT rate was 19% for Black and 31% for White patients (p < 0.001). After adjustment, there was no difference in odds of UT between Black and White patients (aOR 0.97, 95% CI 0.85-1.09, p = 0.58). Among those undertriaged, there was no difference in adjusted odds of mortality between Black and White patients (aOR 0.84, 95% CI 0.62-1.14, p = 0.27).
Conclusions:
After adjustment, there was no evidence of racial disparity in UT or outcomes between Black and White patients.
