Gunshot wounds to the head: racial disparities in inpatient management and outcomes.
OBJECTIVE
Several studies have indicated that racial disparities may exist in the management and outcomes of acute trauma care. One segment of trauma care that has not been as extensively investigated, however, is that of cranial trauma care. The goal of this study was to determine whether significant differences exist among racial and ethnic groups in various measures of inpatient management and outcomes after gunshot wounds to the head (GWH).


METHODS
In this study, the authors used the Nationwide (National) Inpatient Sample (NIS) to investigate all-cause mortality, receipt of surgery, days from admission to initial intervention, discharge disposition, length of hospital stay, and total hospital charges of those with GWH from 2012 to 2016. A 1:1 propensity score-matched analysis was conducted to evaluate the effect of race on these endpoints, while controlling for baseline demographics and comorbidities.


RESULTS
A total of 333 patients met the inclusion and exclusion criteria: 148 (44.44%) white/Caucasian, 123 (36.94%) black/African American, 54 (16.22%) Hispanic/Latinx, and 8 (2.40%) Asian. African American patients were sent to immediate care and rehabilitation significantly less often than Caucasian patients (RR 0.17 [95% CI 0.04-0.71]). There were no significant differences in mortality, length of stay, rates of surgical intervention, or total hospital charges among any of the racial groups.


CONCLUSIONS
The authors' findings suggest that racial disparities in inpatient cranial trauma care and outcomes may not be as prevalent as previously thought. In fact, the disparities seen were only in disposition. More research is needed to further elucidate and address disparities within this population, particularly those that may exist prior to, and after, hospitalization.
['Chiu|Ryan G|RG|', 'Fuentes|Angelica M|AM|', 'Mehta|Ankit I|AI|']
D000293:Adolescent D000328:Adult D000070642:Brain Injuries, Traumatic D005006:Ethnicity D005260:Female D054625:Healthcare Disparities D006760:Hospitalization D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D016896:Treatment Outcome D014481:United States D044465:Whites D014948:Wounds, Gunshot D055815:Young Adult
gunshot wounds to the head racial disparities mortality discharge disposition rehabilitation DRG = Diagnosis Related Group GWH = gunshot wounds to the head NIS = Nationwide (National) Inpatient Sample TBI = traumatic brain injury