Penetrating Colon Trauma Outcomes in Black and White Males

Steven J. Skube, Bruce Lindgren, Yunhua Fan, Stephanie Jarosek, Genevieve B. Melton, Michael D. McGonigal, Mary R. Kwaan

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Racial disparities have been both published and disputed in trauma patient mortality, outcomes, and rehabilitation. In this study, the objective was to assess racial disparities in patients with penetrating colon trauma. Methods: The National Trauma Data Bank was searched for males aged ≥14years from 2010 through 2014 who underwent operative intervention for penetrating colon trauma. The primary outcomes for this study were stoma formation and transfer to rehabilitation; secondary outcomes were postoperative morbidity and mortality. Analyses were performed in 2016–2018. Results: There were 7,324 patients identified (4,916 black, 2,408 white). Black and white patients underwent fecal diversion with stoma formation at a similar rate (19.6% vs 18.5%, p=0.28). Black patients were more likely than white patients to be uninsured (self-pay; 37.1% vs 29.9%) and more likely to be injured by firearms (88.3% vs 70.2%, p<0.001), but had a lower overall postoperative morbidity rate (52.6% vs 55.3%, p=0.04). The odds of stoma formation (OR=0.92, 95% CI=0.78, 1.09, p=0.35) and the odds of transfer to rehabilitation (OR=1.03, 95% CI=0.82, 1.30, p=0.78) were similar for black versus white patients. Conclusions: Black patients experienced similar rates of stoma formation and transfer to rehabilitation as white patients with penetrating colon trauma. Multivariate analysis confirmed expected findings that trauma severity increased the odds of receiving an ostomy and rehabilitation placement. The protocol-based management approach to emergency trauma care potentially decreases the risk for the racial biases that could lead to healthcare disparities. Supplement information: This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Original languageEnglish (US)
Pages (from-to)S5-S13
JournalAmerican journal of preventive medicine
Volume55
Issue number5
DOIs
StatePublished - Nov 2018

Bibliographical note

Funding Information:
Publication of this article was supported by a grant from the National Institute on Minority Health and Health Disparities, National Institutes of Health [grant number U54MD008620]. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the National Institute on Minority Health and Health Disparities or the National Institutes of Health.

Funding Information:
This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

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