Racial/ethnic disparities in morbidity and mortality among adults with cerebrovascular injury following blunt trauma.

OBJECTIVE: To assess the impact of race/ethnicity on adverse events (AEs), in-hospital mortality, and non-routine discharge among BCVI patients. METHODS: A retrospective cohort study was conducted using the American College of Surgeons Trauma Quality Programs Participant Use Files (2017-2023). Multivariable logistic regression analyzed associations between race/ethnicity and clinical outcomes. RESULTS: Among 44,898 BCVI patients, most were non-Hispanic White (NHW, 64.5%), followed by non-Hispanic Black (NHB, 14.9%), Hispanic Latino (HL, 10.5%), and other (10.1%). NHW patients were older and more often injured by falls (27.4%) than NHB (14.9%) and HL (18.2%), p < 0.001. NHB patients had the highest rates of motor vehicle trauma (75.0% vs. 60.5% NHW and 69.7% HL, p < 0.001), AEs (20.5% vs. 17.7% NHW and 19.7% HL, p < 0.001), and longest hospital stays (16.1 ± 21.4 days vs. 12.4 ± 15.1 NHW and 15 ± 18.8 HL, p < 0.001). After adjusting for age, comorbidities, and injury severity, NHB patients had increased odds of AEs (aOR 1.18, 95% CI 1.09-1.28, p < 0.001) and non-routine discharge (aOR 1.11, 95% CI 1.03-1.19, p = 0.004) compared to NHW. HL patients also had higher odds of AEs compared to NHW (aOR 1.11, 95% CI 1.02-1.22, p = 0.022) but lower odds of non-routine discharge (aOR 0.87, 95% CI 0.80-0.95, p < 0.001). CONCLUSIONS: Racial disparities significantly influence BCVI outcomes. NHB and HL patients experienced greater AE risk, with NHB patients also experiencing longer hospitalizations and higher non-routine discharge rates. Targeted interventions are needed to promote equity in trauma care.