Is ethnicity a risk factor for mortality in major trauma? A single-centred cohort study

INTRODUCTION

Many studies have found varying health outcomes in patients from different minority ethnic groups. There has been limited research into the outcomes in major trauma dependent on ethnicity. The aim was to analyse whether ethnicity was an independent risk factor for 30-day mortality in patients presenting to a major trauma centre when adjusting for confounders.

METHODS

This was a retrospective review of all patients presenting to a single major trauma centre from 2010 to 2020. Data were collected on patient demographics and variables including mechanism and injury severity score. Logistic regression was used to determine significant predictors of mortality.

RESULTS

There were 10,668 data sets with ethnicity data; of these 9,098 were of White ethnicity, 1,143 were Asian and 427 were classified as Black. The 30-day mortality rate was 7.76% for White ethnicities, 6.91% for Asian ethnicity and 5.15% for people of Black ethnicity. On multivariate logistic regression, ethnicity (p = 0.076) was not associated with 30-day mortality. Age, Injury Severity Score (ISS), Probability of Survival (PS) score, shock and Glasgow Coma Scale (GCS; p < 0.001) were associated with 30-day mortality. White ethnicity had an odds ratio (OR) of mortality of 1.16 (95% confidence interval [CI] 0.658-2.040) (p = 0.609) compared with Black ethnicity and an OR of 0.74 (95% CI 0.546-1.001) (p = 0.050) compared with Asian patients. Black patients had an OR of mortality of 0.65 (95% CI 0.351-1.193) (p = 0.164) compared with the Asian population.

CONCLUSION

Ethnicity is not a significant risk factor for 30-day mortality in trauma patients.

Lysosomal acid phosphatase: activity and isoenzymes in separated normal human blood cells

The present study was devised to investigate the activity and isoenzymes of lysosomal acid phosphatase in individual normal human blood cells, including the T- and B-population of lymphocytes, with the aim to contribute to the classification of haematopoietic neoplasias on the basis of cell specific isoenzyme patterns. Platelets, erythrocytes, granulocytes, monocytes and T-lymphocytes were isolated from blood by gradient centrifugation or immune adsorption. B-lymphocytes were obtained from human tonsils. After purity control and isolation of lysosomes the concentration of acid phosphatase was assayed using the conventional spectrophotometric method. Isoenzymes were separated by isoelectric focusing on polyacrylamide thin layer slabs. Monocytes revealed the highest activity with 14 mU/10(7) cells, about three times more than granulocytes. T-lymphocytes showed an activity of 2.85 mU/10(7) cells and B-lymphocytes of 1.83 mU/10(7) CELLS. The lowest activity was found in platelets with 0.08 mU/10(7) cells. Granulocytes showed 12 isoenzyme bands, whilst the number for monocyte, B-lymphocytes, T-lymphocytes and platelets were respectively 11, 12, 1 and 4 isoenzyme bands. Thus it became evident that the different blood cell populations can be distinguished on the basis of their acid phosphatase isoenzyme pattern.

[Social security for people in need of care -- proposals for the development and financing of aids for this group (author's transl)]

The article points out a serious deficiency in the social security system, i.e., that the old and infirm can only seldon obtain institutional care without calling on social assistance. It discusses possible solution of including the attendance allowances into the scope of social security benefits. The solutions are formulated in the amendment of the Association of German Cities and Towns (Deutscher Städtetag) to the insurance regulations of the earlier German Reich (Reichsversicherungsordnung). It is proposed that the Länder and communities as well as, to a small extent the Federal Government, assume the responsibility for investments, whereas the legal sickness insurance funds cover the costs for medical treatment and nursing and the patient pays an estimated rent value and the "hotel services".