Aug 7 When children have minor, but high-risk,
head injuries, race doesn't seem to be a factor determining who
gets sent for CT scanning, a U.S. study said. But for lower-risk
injuries, white children get more, and likely too many, of the
Researchers, whose results appeared in the Archives of
Pediatrics & Adolescent Medicine, found that of 39,717 children
across the United States with minor head trauma, about 42
percent of the white children had CT cans of the head while 28
percent of black and Hispanic children got the scans.
The difference doesn't mean that black and Hispanic children
were getting worse care, the researchers said. Rather, the white
children could be getting unnecessary and potentially risky care
- in part, because their parents demand it.
"It's often that the minority groups get worse care, but
what we found is that the whites are more likely to get CT scans
that are not indicated and could be risky because of the
radiation exposure, said JoAnne Natale, the study's lead author
and a professor of pediatrics at the University of California,
"(In this case) it's actually opposite because the black
sand Hispanics are getting better care... and the whites are
getting too much (care)."
Traumatic brain injuries - usually caused by blows to the
head - account for more than 7,000 deaths, 60,000 hospital
admissions and 600,000 emergency room visits in the United
States every year, according to Natale and her colleagues.
Past research has found that black kids typically fare worse
than whites after such an injury.
To see whether there were racial differences in the
treatment kids received, Natale's group looked at who got a head
CT, a fairly typical scan for head injury, in emergency rooms.
They analyzed data from a large existing study looking at 25
emergency rooms across the United States, where doctors were
asked to complete questionnaires about children treated for head
trauma between June 2004 and September 2006.
The study covered more than 42,000 children under 18 seen
within 24 hours of a minor head injury. "Minor" was defined as
more serious than just a bump on the head, but excluded very
severe head trauma.
Within the minor injury category, there can be high,
intermediate and low levels of risk, as determined by the
specific circumstances of the injury and the child's symptoms.
Children in the highest risk groups typically get CT scans
because their symptoms are serious, such as unconsciousness.
There were no differences in treatment based on race or
ethnicity, Natale and her colleagues found.
But in the intermediate risk group, 58 percent of white
children got scans compared to 51 percent of black children.
In the lowest-risk group, 17 percent of white children got
scanned compared to 10 percent of the black and Hispanic
Natale and her team said they couldn't say from their data
why white children got scanned more. But across the board,
doctors said parental anxiety and requests played more of a role
in treatment of white children.
Other factors may be at work as well, since the results
didn't take into account insurance status or specific reasons
doctors didn't order a CT scan for some children.
(Reporting from New York by Andrew Seaman at Reuters Health;
editing by Elaine Lies)