Highlights
- •Little is known about potential disparities in end-of-life trauma care.
- •Adjusted odds of Withdrawal of Life Sustaining Treatment were lower in Blacks (OR 0.48 and Hispanics (OR 0.71) than Whites.
- •Among non-head injured dying patients, Blacks and Hispanics are less likely to utilize WLST than Whites.
- •Further investigation into the socio-cultural norms and institutional distrust influencing these differences is imperative.
Abstract
Background
Little is known about potential disparities in end-of-life care in trauma. We examined
racial/ethnic differences in withdrawal of life-sustaining treatment (WLST) in non-head
injury trauma.
Methods
We retrospectively analyzed the National Trauma Databank (2017–2018), including patients ≥ 18
years without head injury. We performed a bivariate analysis by WLST status and used
logistic regression to estimate adjusted odds of WLST by racial/ethnic group.
Results
Of 942,914 identified, 20,052 (2.1%) died. Of those who died, WLST occurred in 29.9%.
The adjusted odds of WLST were lower in Blacks (OR 0.48, 95% CI 0.41–0.57) and Hispanics
(OR 0.71, 95% CI 0.57–0.89) than Whites. The predicted probability of WLST in Black
patients remained lower than Whites at 30 days.
Conclusions
Among non-head injured dying patients, Blacks and Hispanics are less likely to utilize
WLST than Whites. Further investigation into the socio-cultural norms and institutional
distrust influencing these differences is imperative.
Keywords
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Article info
Publication history
Published online: August 05, 2021
Accepted:
August 3,
2021
Received in revised form:
July 21,
2021
Received:
June 7,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
