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Citation
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Hambrecht A, Schellenberg M, Owattanapanich N, Boyle KA, Ugarte C, Ambrose C, Matsushima K, Martin MJ, Inaba K. Am. Surg. 2024; ePub(ePub): ePub. |
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Abstract
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INTRODUCTION: An increasing proportion of the population identifies as non-binary. This marginalized group may be at differential risk for trauma compared to those who identify as male or female, but physical trauma among non-binary patients has not yet been examined at a national level.
METHODS: All patients aged ≥ 16 years in the National Trauma Data Bank were included (2021-2022). Demographics, injury characteristics, and outcomes after trauma among non-binary patients were compared to males and females. The goal was to delineate differences between groups to inform the care and future study of non-binary trauma patients.
RESULTS: In total, 1,012,348 patients were included: 283 (<1%) non-binary, 610,904 (60%) male, and 403,161 (40%) female patients. Non-binary patients were younger than males or females (median age 44 vs 49 vs 67 years, P <.001) and less likely to be White race/ethnicity (58% vs 60% vs 74%, P <.001). Despite non-binary patients having a lower median Injury Severity Score (5 vs 9 vs 9, P <.001), mortality was highest among non-binary and male patients than females (5% vs 5% vs 3%, P <.001).
DISCUSSION: In this study, non-binary trauma patients were younger and more likely minority races/ethnicities than males or females. Despite having a lower injury severity, non-binary patient mortality rates were comparable to those of males and greater than for females. These disparities identify non-binary trauma patients as doubly marginalized, by gender and race/ethnicity, who experience worse outcomes after trauma than expected based on injury severity. This vulnerable patient population deserves further study to identify areas for improved trauma delivery care.
Language: en |