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Race and Older Trauma Patients in the ER

Researchers found older white trauma patients were 20 percent more likely to die

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

WEDNESDAY, May 28, 2014 (HealthDay News) -- Older black trauma patients are 20 percent more likely to survive their injuries than their white peers are, a new study shows.

The finding is surprising because studies typically show that black trauma patients have worse outcomes than whites, the Johns Hopkins University School of Medicine researchers noted.

For the study, the investigators analyzed in-hospital death rates among nearly 1.1 million trauma patients treated at U.S. hospitals from 2003 through 2010. Among patients aged 16 to 64, blacks were 20 percent more likely to die than whites. However, among patients aged 65 and older, whites were 20 percent more likely to die than blacks, the team found.

"We have long found it vexing that minority patients consistently do worse, even in treatment for trauma that seems to leave little room for bias," study leader Dr. Adil Haider, an associate professor of surgery, said in a Hopkins news release.

"And although we still see the disparity in younger black patients, we were surprised to find in this study that older black trauma patients were more likely to survive their injuries," he added.

Far more of the older patients suffered blunt trauma injuries -- mainly from traffic accidents and falls -- while younger patients were much more likely to have gunshot or stab wounds.

The researchers also found that nearly all of the older patients (99.4 percent) had insurance, many of them through Medicare. This high percentage of coverage means that all older patients have better access to health care, which helps "level the playing field" among older patients of different races, Haider said.

Another possible reason for the finding is that black patients have worse outcomes from disease and injury throughout their lives, so they have what the researchers called a "healthy survivor bias."

"There are well-documented disparities in access to health care for younger black patients, so it is possible that black patients who make it to age 65 have potentially reached that age stronger and healthier than their white counterparts of a similar age," study co-author and surgical resident Dr. Caitlin Hicks said in the news release.

"This is an important finding in racial disparities research that we need to look into and learn from," she added.

The study was published online May 28 in the journal JAMA Surgery.

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