Disparities in Care Among Gunshot Victims: A Nationwide Analysis

Reynold Henry, Panagiotis K. Liasidis, Blade Olson, Damon Clark, Tatiana Hoyos Gomez, Cameron Ghafil, Li Ding, Kazuhide Matsushima, Martin Schreiber, Kenji Inaba

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Given the well-known healthcare disparities most pronounced in racial and ethnic minorities, trauma healthcare in underrepresented patients should be examined, as in-hospital bias may influence the care rendered to patients. This study seeks to examine racial differences in outcomes and resource utilization among victims of gunshot wounds in the United States. Methods: This is a retrospective review of the National Trauma Data Bank (NTDB) conducted from 2007 to 2017. The NTDB was queried for patients who suffered a gunshot wound not related to accidental injury or suicide. Patients were stratified according to race. The primary outcome for this study was mortality. Secondary outcomes included racial differences in resource utilization including air transport and discharge to rehabilitation centers. Univariate and multivariate analyses were used to compare differences in outcomes between the groups. Results: A total of 250,675 patients were included in the analysis. After regression analysis, Black patients were noted to have greater odds of death compared to White patients (odds ratio [OR] 1.14, confidence interval [CI] 1.037-1.244; P = 0.006) and decreased odds of admission to the intensive care unit (ICU) (OR 0.76, CI 0.732-0.794; P < 0.001). Hispanic patients were significantly less likely to be discharged to rehabilitation centers (Hispanic: 0.78, CI 0.715-0.856; P < 0.001). Black patients had the shortest time to death (median time in minutes: White 49 interquartile range [IQR] [9-437] versus Black 24 IQR [7-205] versus Hispanic 39 IQR [8-379] versus Asian 60 [9-753], P < 0.001). Conclusions: As society carefully examines major institutions for implicit bias, healthcare should not be exempt. Greater mortality among Black patients, along with differences in other important outcome measures, demonstrate disparities that encourage further analysis of causes and solutions to these issues.

Original languageEnglish (US)
Pages (from-to)59-69
Number of pages11
JournalJournal of Surgical Research
Volume283
DOIs
StatePublished - Mar 2023

Keywords

  • Gunshot wound
  • Interpersonal violence
  • Racial disparities
  • Trauma

ASJC Scopus subject areas

  • Surgery

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