Original Research Article| Volume 223, ISSUE 5, P998-1003, May 2022

Racial and ethnic disparities in withdrawal of life-sustaining treatment after non-head injury trauma


      • 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.



      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.


      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.


      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.


      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.


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