The Influence of Race on the Development of Acute Lung Injury in Trauma Patients

Outcomes and incidence for certain chronic diseases, such as hypertension, vary among different racial and ethnic groups, but it is unclear if there is a similar effect in acute illnesses. This retrospective cohort study investigated the effect of race on mortality due to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The authors reviewed the charts of 4397 adult trauma patients, including 1831 Caucasians, 871 African-Americans, 886 Hispanics, and 809 Asian/Pacific Islanders requiring intensive care unit admission at an urban teaching hospital in San Francisco, California. There were 219 patients identified who developed ALI/ARDS within 72 h of admission. The overall incidence of ALI/ARDS in the study was 5% and was similar across all racial cohorts. The incidence among Asian/Pacific Islanders was 7.7%, among Hispanics was 7.2%, among African-Americans was 5.8%, and among Caucasians was 4.8%. Additionally, the 95% confidence interval among all groups included the value 1, leading to the authors’ conclusion that there is no difference in the incidence of ALI/ARDS among the racial groups compared in this study. There were, however, significant differences between racial groups in other areas, such as age (highest in Asian/Pacific Islanders), percentage requiring massive transfusion (highest in African-Americans), and percentage incidence of penetrating trauma (highest in African-Americans and Hispanics).