The Hispanic paradox: does it exist in the injured?

• We analyze National Trauma Data Bank patients, classifying groups by race/ethnicity.
• We examine if the “Hispanic Paradox” exists in injured patients.
• We compare Hispanic, non-Hispanic White, and African American mortality outcomes.
• Hispanic patients have similar or better mortality risk compared with other groups.
• The “Hispanic Paradox” exists in the injured, although the cause is unknown.

BackgroundHispanics have similar or lower all-cause mortality rates in the general population than non-Hispanic whites (NHWs), despite higher risks associated with lower socioeconomic status, hence termed the “Hispanic Paradox.” It is unknown if this paradox exists in the injured. We hypothesized that Hispanic trauma patients have equivalent or lower risk-adjusted mortality and observed-to-expected mortality ratios than other racial/ethnic groups.MethodsRetrospective analysis of adult patients from the 2010 National Trauma Data Bank was performed. Hispanic patients were compared with NHWs and African Americans (AAs) to assess in-hospital mortality risk in each group.ResultsCompared with NHWs, Hispanic patients had lower unadjusted risk of mortality. After adjusting for potential confounders, the difference was no longer statistically significant. Mortality risk was significantly lower for Hispanic patients compared with AAs in both crude and adjusted models. Hispanic patients had significantly lower observed-to-expected mortality ratios than NHWs and AAs.ConclusionDespite reports of racial/ethnic disparities in trauma outcomes, Hispanic patients are not at greater risk of death than NHW patients in a nationwide representative sample of trauma patients.