The Journal of surgical research · 2025
Social and Racial Disparity Impacts Victims of Physical Abuse Among Trauma Patients.
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Zangbar Bardiya, Rafieezadeh Aryan, Jose Anna, Kirsch Jordan, Shnaydman Ilya, Froula Gabriel, Klein Joshua, Bronstein Matthew, Prabhakaran Kartik
Аннотация
BACKGROUND: Violence in the form of physical abuse is an underreported crime and a significant social problem in the United States. However, the true burden of the problem as well as the predictors of intervention remain unknown. The aim of our study was to assess the prevalence of physical abuse among trauma patients, and to identify the predictors of investigation of physical abuse by law enforcement and change in caregiver on discharge.
METHODS: A 3-y (2017-2019) retrospective analysis of the Trauma Quality Improvement Program database was performed, which included a total of 3,138,896 trauma patients. Trauma patients who had reported physical abuse were identified. Patients were stratified by age into the following 3 groups: pediatric (<18 y), adults (18-65 y), and geriatric patients (>65 y). We also performed multivariate logistic regression analysis to examine the effects of different patient characteristics on the likelihood of change in caregiver and investigation.
RESULTS: A total of 26,043 patients were identified who had reported physical abuse of which 44.1% (n = 11,490) were pediatric, 49.9% (n = 13,001) were adults, and 6% (n = 1552) were geriatric. Among different age groups, reported physical abuse was higher in American Indians, Blacks, Pacific Islanders, Asians, and Whites, respectively. Male gender (odds ratio [OR] = 1.706, 95% confidence interval [CI; 1.706-1.566]), Black race (OR = 1.222, 95% CI [1.111-1.346]) and injury severity score (OR = 1.005, CI 95% [1.001-1.010]) were the predictors for change of a caregiver at the time of discharge. Evaluation of predictors for initiating an investigation enforcement showed that Black race (OR = 2.55, 95% CI [1.94-3.35]) was strongest.
CONCLUSIONS: Among trauma patients, racial disparity exists in reporting, investigating, and changing of the caregiver in cases with reported physical abuse. Further studies are warranted to identify possible underlying causes of disparities in reporting, investigation, and intervention for victims of abuse.
METHODS: A 3-y (2017-2019) retrospective analysis of the Trauma Quality Improvement Program database was performed, which included a total of 3,138,896 trauma patients. Trauma patients who had reported physical abuse were identified. Patients were stratified by age into the following 3 groups: pediatric (<18 y), adults (18-65 y), and geriatric patients (>65 y). We also performed multivariate logistic regression analysis to examine the effects of different patient characteristics on the likelihood of change in caregiver and investigation.
RESULTS: A total of 26,043 patients were identified who had reported physical abuse of which 44.1% (n = 11,490) were pediatric, 49.9% (n = 13,001) were adults, and 6% (n = 1552) were geriatric. Among different age groups, reported physical abuse was higher in American Indians, Blacks, Pacific Islanders, Asians, and Whites, respectively. Male gender (odds ratio [OR] = 1.706, 95% confidence interval [CI; 1.706-1.566]), Black race (OR = 1.222, 95% CI [1.111-1.346]) and injury severity score (OR = 1.005, CI 95% [1.001-1.010]) were the predictors for change of a caregiver at the time of discharge. Evaluation of predictors for initiating an investigation enforcement showed that Black race (OR = 2.55, 95% CI [1.94-3.35]) was strongest.
CONCLUSIONS: Among trauma patients, racial disparity exists in reporting, investigating, and changing of the caregiver in cases with reported physical abuse. Further studies are warranted to identify possible underlying causes of disparities in reporting, investigation, and intervention for victims of abuse.