Darla Fink, MD,
Pediatrics Resident Physician
Rainbow Babies & Children's Hospital
Cleveland, Ohio
Disclosure information not submitted.
Michael Dingeldein, MD
Trauma Director
Rainbow Babies & Children's Hospital, United States
Disclosure information not submitted.
Jerri Rose, MD
Program Director, Pediatric Emergency Medicine
Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, United States
Disclosure information not submitted.
Katherine Slain, DO
Dr.
Rainbow Babies and Childrens Hospital, United States
Disclosure information not submitted.
Title: Differences in Mortality by Race in Critically Injured Children with Traumatic Brain Injury
Introduction/Hypothesis: In the United States (US), Black children are more likely to die from traumatic injury than White children. Differences in mortality rates based on race/ethnicity for children with traumatic brain injury (TBI) requiring admission to the pediatric intensive care unit (PICU) are unknown.
Methods: A retrospective analysis of the Virtual Pediatric Systems (VPS, LLC; Los Angeles, CA) from 1/1/2018 – 12/31/2019 was performed. Children < 19 years of age admitted to a US PICU with TBI were identified using STAR codes. Children were categorized as White, Black, Hispanic, Asian, or “Other” race. Differences in patient demographics, PICU and hospital length of stay (LOS), and mortality were compared across races using chi square tests.
Results: Among this cohort of 4,073 children admitted to a US PICU with TBI, 48.1% (n=1958) were categorized as White race, 14.3% (n = 584) were Black, 23.4% (n=954) were Hispanic ethnicity, 5.1 % (n=206) were Asian, and 9.1% (n=371) were Other race. Most children were ages 29 days to 2 years old (30.2%) and 25.9% were adolescent children ages 12 to 18 years old. Males accounted for 64.6% of the children. Most children had a mild TBI (n=2484, 61%), while 15.5% (n=630) suffered a moderate TBI and 23.5% (n=959) suffered a severe TBI. Among the 277 children who died, there were differences in mortality rate by race (White (6.7%) vs Black (6.3%) vs Hispanic (23.3% ) vs Asian (1.9% ) vs Other (8.4%), p< 0.001). We also found differences between races in the PICU LOS (p < 0.001) and hospital LOS (p < 0.001). Black children had the longest hospital LOS (3.58 days [IQR 1.62-9.00]), while Asian children had the shortest hospital LOS (1.84 days [IQR 0.91-4.17]).
Conclusions: This cohort of TBI patients admitted to US PICU demonstrated that there are differences in PICU length of stay, hospital length of stay, and mortality among the races. Further studies are required to understand why these differences exist.