• Jessica Wallace, Ryan Moran, Abigail Bretzin, Barbara Hileman, and Gregory S Huang.
• Department of Health Science, The University of Alabama, Tuscaloosa, Alabama; Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
• J Emerg Med. 2020 Dec 1; 59 (6): 783-794.

BackgroundGiven the frequency, severity, and attention of traumatic brain injury in children, benchmarking disparities and injury characteristics for adolescent patients is pivotal in understanding and enhancing both clinical care and outcomes.ObjectivesThe purpose of this study was to investigate racial disparities on mechanism of injury, clinical outcomes, and social-health factors among adolescents treated in the emergency department (ED) for a head, neck, or brain injury.MethodsThis study is the result of a retrospective chart review of head-, neck-, and brain-injured adolescent patients (n = 2857) treated at three community hospital EDs and one stand-alone ED. Outcome measures included patient demographics (gender, race/ethnicity, age), Glasgow Coma Scale score, hospital length of stay, intensive care unit length of stay, mechanism of injury, primary diagnosis, secondary diagnosis of a concussion, ventilation days, discharge disposition, and primary insurance.ResultsThere were racial differences in primary diagnosis, mechanism of injury, and insurance status. Results indicated that a higher proportion of white patients were diagnosed with a concussion compared with black patients (p < 0.001). Moreover, a higher proportion of white patients were seen in the ED for head, neck, or brain injury as a result of a sports or motor vehicle incident, whereas a leading mechanism among black patients was assault (p = 0.01). More white patients had private insurance, whereas more black patients had Medicaid (p < 0.001).ConclusionThe disparities in mechanisms for which black and white adolescent patients are seeking care at the ED for head, neck, or brain injury help to identify social-health risks of sustaining a head, neck, or brain injury. These racial disparities between black and white adolescents seen at the ED for head, neck, or brain injury suggest the need for further research to better understand the national representation of these disparities.Copyright © 2020 Elsevier Inc. All rights reserved.

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