Racial disparities in craniomaxillofacial trauma

Racial disparities have been shown to exist in several arenas of health care. The institutional trauma registry at Boston Medical Center was queried to investigate racial injury patterns and outcomes in craniomaxillofacial trauma from 2001 to 2010. 2357 complete records were reviewed that met inclusion criteria based on ICD-9 codes. Multivariate/bivariate logistic regression was used to analyze data.

There were distinct differences in injury mechanism based on race. Less than 1% of White patients were admitted for ballistic injuries compared to 13.1% of Blacks and 5.8% of Asians. The male:female ratio amongst Blacks, Hispanics and Whites was 6:1, 4:1 and 2.5:1 respectively. Death following ICU admission was related to age, shock, GCS, ISS, but not race ( p < 0.0001). The risk of mortality was greater in patients with gun shot wounds (OR 14.3, p < 0.0001) and with admission systolic blood pressure < 90 mmHg (OR 12.3, p < 0.0001) Length of stay among non-ICU patients was strongly related to ISS, a diagnosis of shock on admission, increasing numbers of surgical procedures; OR 0.28, 0.98, 1.09, p < 0.001. Relationships between race, length of stay or insurance status did not reach statistical significance.

This study illustrates distinct differences in injury patterns according to race, however there were no statistically relevant relationships between race, gender and cause specific mortality. Shock, decreased GCS and increased ISS were the most powerful predictors of outcome. The data strongly suggest that while racial disparities exist in the mechanism of injury, patient outcomes were similar irrespective of race.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Racial disparities in craniomaxillofacial trauma
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