Racial disparities and the acute management of severe blunt traumatic brain injury

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, affecting people of all ages, genders, races and ethnicities, and socioeconomic backgrounds. Despite the universal occurrence of TBI, research suggests that non-white patients experience poorer health outcomes after sustaining these injuries. Researchers remain uncertain of where these disparities occur along the pathway of care, indicating a need to investigate the clinical care process to identify existing gaps in TBI monitoring and intervention for patients of color.

A research team in California conducted a study of 3,692 adults who were hospitalized for severe blunt-force TBI over a 10-year period. They used hospital records to determine each patient’s race, insurance status, and care received (such as intracranial pressure monitoring and neurosurgical procedures). They found that:

  • White and non-white patients received the same standard of post-injury brain monitoring and intervention procedures.
  • Non-white patients were disproportionately more likely to be younger, uninsured, and suffer from congestive heart failure than non-white patients.
  • After sustaining TBI, white patients stayed in the hospital for significantly less time than non-white patients.

Although white and non-white patients appear to receive the same standard of acute TBI care, non-white patients are more likely to remain in the hospital for longer and are less likely to have insurance coverage than white patients. Researchers suspect that racial disparities in TBI outcomes are related to the immense financial burden associated with out-of-pocket medical treatment, suggesting an urgent need to improve access to medical insurance for people of color and their families. Researchers and clinicians alike remain dedicated to promoting equitable health care, ensuring that every patient receives optimal treatment and is able to return to a fulfilling quality of life.

Sharma R, Johnson A, Li J, et al. Racial disparities and the acute management of severe blunt traumatic brain injury. Trauma Surgery and Acute Care Open. (September 2019).

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