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    Health disparities in acute outcomes of life-threatening injur

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    Authors
    NeSmith, Elizabeth Grooms
    Issue Date
    2007-12
    URI

    http://hdl.handle.net/10675.2/623259
    
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    Abstract
    Health disparities have been documented in nearly all-leading causes of death. It is unknown if health disparities also exist in acute outcomes of lifethreatening injury. The overall research question for this dissertation was, "Do health disparities exist in acute outcomes of life-threatening injury?". Three studies were conducted: a state of science, a validity study, and a descriptive study. The state of the science showed that only 4 of 352 studies repo'rted disparities, while 3 of 352 studies reported no disparities. The validity study was a retrospective chart review and showed that the instrument used to measure systemic inflammatory response syndrome was valid in predicting intensive care unit length of stay (F = 15.83) p < .0001. Caucasian race also predicted intensive care unit length of stay (F = 9. 7) p = .002. When combined with race, the systemic inflammatory response syndrome instrument explained . more variance (R2 = .15) in intensive care uniflength of stay than either variable alone (F = 7.7) p = .006. The descriptive study utilized the same data set from the validity study, and showed fewer occurrences of systemic inflammatory response syndrofDe in African Americans than in Caucasians (T = 9949.5) p = .04; in adults 30-44 years old than in adults 18-29 (T = 13,654) p = .04; and in ethyl alcohol users than in all other substance users (X2 = 7 .85) p = .005. There was less severity of systemic : inflammatory response syndrome in females than in males {T = 7,491.5) p = .03; I / and in marijuana users than in all other substance users (T = 3, 117),P = .02 . . More severity of systemic inflammatory response syndrome was found among ethyl alcohol users than in all other substance users {T = 2,667) p = .0008. Results support that health disparities exist among different patient groups · according to race, age, sex, and substance use for systemic inflammatory response syndrome. More research is needed to determine if these disparities translate to ·increased risk for poor outcomes. _Implications for practice include 1 increased vigilance of different patient groups- based on occurrence and severity of systemic inflammatory response syndrome.
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    School of Graduate Studies
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