Racial and Ethnic Disparities Among Minority Geriatric Trauma Patients in the United States: An Analysis of Data From a National Sample Using the Trauma Quality Improvement Program Database

Abstract

For this dissertation, I completed three manuscripts with the common overall aim of assessing health disparities among geriatric trauma patients in the U.S. The first manuscript reports on a structured narrative review of the literature comprised of three approaches that ensure comprehensive and targeted research: a scoping review, an exploratory search, and a citation review. The second manuscript is a descriptive analysis of one-year (2016) of data from the American College of Surgeon’s Trauma Quality Improvement Program (ACS-TQIP) with a focus on older adults aged 65 and older who have had an injury. The population was stratified into four groups: Non-Hispanic Whites (NHWs), African Americans, Hispanics, and Other races. For each group, I conducted a simple univariate tabulation for key demographic characteristics and injury-related variables. I also assessed comorbidities, insurance type, and regional differences. Finally, in manuscript three, I performed a one-year analysis of the ACS-TQIP dataset and included all adult trauma patients aged 65 and older who were admitted in 2016. My primary aim was to understand health disparities regarding in-hospital health measures, such as in-hospital mortality, length of stay (LOS), and in-hospital complications. I conducted multivariable regression analysis controlling for age, gender, injury severity, comorbidities, insurance status, calendar year, and type of trauma center. I argue that racial/ethnic disparity exists for GTPs in terms of in-hospital mortality, in-hospital complications, and LOS. Type of injury, severity of injury, and age group are critical predictors of different health outcomes among minority GTPs. Minimizing disparities in GTPs care is crucial to reducing morbidity and mortality. More focused primary research is needed to expand our knowledge of racial/ethnic disparities among GTPs. It is critical that future research stratify each minority group by differences in injury type, injury severity, and age group.