US children of minority race are less likely to be admitted to the pediatric intensive care unit after traumatic injury, a retrospective analysis of a single pediatric trauma center

Injury Epidemiology

Jerri A. Rose¹  Katherine N. Slain²  Morgan A. Wurtz³ 

[1] Case Western Reserve University School of Medicine, Cleveland, OH, USA;Department of Pediatrics, Division of Pediatric Emergency Medicine, UH Rainbow Babies & Children’s Hospital, 11100 Euclid Avenue, Mailstop RBC 6002, 44106, Cleveland, OH, USA;Department of Pediatrics, Division of Pediatric Critical Care, University Hospitals Rainbow Babies & Children’s Hospital, 11100 Euclid Avenue, Mailstop RBC 6010, 44106, Cleveland, OH, USA;Case Western Reserve University School of Medicine, Cleveland, OH, USA;Department of Pediatrics, Division of Pediatric Emergency Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, 43205, Columbus, OH, USA;

关键词: Pediatric trauma;    Critical care;    Racial disparities;    Hospital utilization;   

DOI  :  10.1186/s40621-021-00309-x

来源: Springer

【 摘 要 】

BackgroundThe public health impact of pediatric trauma makes identifying opportunities to equalize health related disparities imperative. The influence of a child’s race on the likelihood of admission to the pediatric intensive care unit (PICU) is not well described. We hypothesized that traumatically injured children of minority race would have higher rates of PICU admission, compared to White children.MethodsThis was a retrospective review of a single institution’s trauma registry including children ≤18 years of age presenting to the emergency department (ED) whose injury necessitated pediatric trauma team activation at a Level 1 Pediatric Trauma Center from July 1, 2011 through June 30, 2016. Demographics, injury characteristics and hospital utilization data were collected. Race was categorized as White or racial minority, which included patients identifying as Black, Hispanic ethnicity, Native American or “other.” The primary outcome measure was admission to the PICU. Chi square or Mann Whitney rank sum tests were used, as appropriate, to compare differences in demographics and injury characteristics between those children who were and were not admitted to the PICU setting. Variables associated with PICU admission in univariate analyses were included in a multivariate analysis. Data are presented as median values and interquartile ranges, or numbers and percentages.ResultsThe median age of the 654 included subjects was 8 [IQR 4–13] years; 55.2% were a racial minority. Nine (1.4%) children died in the ED and 576 (88.1%) were admitted to the hospital. Of the children requiring hospitalization, 195 (33.9%) were admitted to the PICU. Children admitted to the PICU were less likely to be from a racial minority group (26.1% vs 42.5%, p < 0.001). After adjusting for age and injury characteristics in a multivariable analysis, racial minority children had a lower odds of PICU admission compared to White children (OR 0.492 [95% C.I. 0.298–0.813, p = 0.006]).ConclusionsIn this retrospective analysis of traumatically injured children, minority race was associated with lower odds of PICU admission, suggesting that health care disparities based on race persist in pediatric trauma-related care.

【 授权许可】

CC BY