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Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: the case for inner-city pedestrian injury prevention programs.
Surgery. 2010 Aug; 148(2):202-8.S

Abstract

BACKGROUND

Pedestrian trauma is the most lethal blunt trauma mechanism, and the rate of mortality in African Americans and Hispanics is twice that compared with whites. Whether insurance status and differential survival contribute to this disparity is unknown.

METHODS

This study is a review of vehicle-struck pedestrians in the National Trauma Data Bank, v7.0. Patients <16 years and > or =65 years, as well as patients with Injury Severity Score (ISS) <9, were excluded. Patients were categorized as white, African American, or Hispanic, and as privately insured, government insured, or uninsured. With white and privately insured patients as reference, logistic regression was used to evaluate mortality by race and insurance status after adjusting for patient and injury characteristics.

RESULTS

In all, 26,404 patients met inclusion criteria. On logistic regression, African Americans had 22% greater odds of mortality (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.06-1.41) and Hispanics had 33% greater odds of mortality (OR, 1.33; 95% CI, 1.14-1.54) compared with whites. Uninsured patients had 77% greater odds of mortality (OR, 1.77; 95% CI, 1.52-2.06) compared with privately insured patients.

CONCLUSION

African American and Hispanic race, as well as uninsured status, increase the risk of mortality after pedestrian crashes. Given the greater incidence of pedestrian crashes in minorities, this compounded burden of injury mandates pedestrian trauma prevention efforts in inner cities to decrease health disparities.

Authors+Show Affiliations

Department of Surgery, Georgetown University Hospital, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20633726

Citation

Maybury, Rubie Sue, et al. "Pedestrians Struck By Motor Vehicles Further Worsen Race- and Insurance-based Disparities in Trauma Outcomes: the Case for Inner-city Pedestrian Injury Prevention Programs." Surgery, vol. 148, no. 2, 2010, pp. 202-8.
Maybury RS, Bolorunduro OB, Villegas C, et al. Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: the case for inner-city pedestrian injury prevention programs. Surgery. 2010;148(2):202-8.
Maybury, R. S., Bolorunduro, O. B., Villegas, C., Haut, E. R., Stevens, K., Cornwell, E. E., Efron, D. T., & Haider, A. H. (2010). Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: the case for inner-city pedestrian injury prevention programs. Surgery, 148(2), 202-8. https://doi.org/10.1016/j.surg.2010.05.010
Maybury RS, et al. Pedestrians Struck By Motor Vehicles Further Worsen Race- and Insurance-based Disparities in Trauma Outcomes: the Case for Inner-city Pedestrian Injury Prevention Programs. Surgery. 2010;148(2):202-8. PubMed PMID: 20633726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: the case for inner-city pedestrian injury prevention programs. AU - Maybury,Rubie Sue, AU - Bolorunduro,Oluwaseyi B, AU - Villegas,Cassandra, AU - Haut,Elliott R, AU - Stevens,Kent, AU - Cornwell,Edward E,3rd AU - Efron,David T, AU - Haider,Adil H, PY - 2010/01/09/received PY - 2010/04/13/accepted PY - 2010/7/17/entrez PY - 2010/7/17/pubmed PY - 2010/8/7/medline SP - 202 EP - 8 JF - Surgery JO - Surgery VL - 148 IS - 2 N2 - BACKGROUND: Pedestrian trauma is the most lethal blunt trauma mechanism, and the rate of mortality in African Americans and Hispanics is twice that compared with whites. Whether insurance status and differential survival contribute to this disparity is unknown. METHODS: This study is a review of vehicle-struck pedestrians in the National Trauma Data Bank, v7.0. Patients <16 years and > or =65 years, as well as patients with Injury Severity Score (ISS) <9, were excluded. Patients were categorized as white, African American, or Hispanic, and as privately insured, government insured, or uninsured. With white and privately insured patients as reference, logistic regression was used to evaluate mortality by race and insurance status after adjusting for patient and injury characteristics. RESULTS: In all, 26,404 patients met inclusion criteria. On logistic regression, African Americans had 22% greater odds of mortality (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.06-1.41) and Hispanics had 33% greater odds of mortality (OR, 1.33; 95% CI, 1.14-1.54) compared with whites. Uninsured patients had 77% greater odds of mortality (OR, 1.77; 95% CI, 1.52-2.06) compared with privately insured patients. CONCLUSION: African American and Hispanic race, as well as uninsured status, increase the risk of mortality after pedestrian crashes. Given the greater incidence of pedestrian crashes in minorities, this compounded burden of injury mandates pedestrian trauma prevention efforts in inner cities to decrease health disparities. SN - 1532-7361 UR - https://www.unboundmedicine.com/medline/citation/20633726/Pedestrians_struck_by_motor_vehicles_further_worsen_race__and_insurance_based_disparities_in_trauma_outcomes:_the_case_for_inner_city_pedestrian_injury_prevention_programs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0039-6060(10)00273-4 DB - PRIME DP - Unbound Medicine ER -