The Journal of Trauma: Injury, Infection, and Critical Care 2003; 54(5):967-972

The Risk of Death for Jehovah's Witnesses after Major Trauma

J. Esteban Varela, MD, MPH; Orlando Gomez-Marin, MSc, PhD; Lora E. Fleming, MD, PhD; Stephen M. Cohn, MD, FACS

Background:
Trauma surgeons are faced with life-threatening blood loss in patients such as Jehovah's Witnesses. We assessed and compared the risks of death after major trauma for Jehovah's Witnesses and other religious groups.

Methods:
A retrospective cohort study was conducted between August 1992 and September 1999 in a Level I academic trauma center. Statistical methods included Tukey's one-way analysis of variance, ÷2 analysis, and bivariate and multivariate logistic regression analyses.

Results:
The cohort consisted of 556 patients: 82 Jehovah's Witnesses (14.7%), 52 Baptists (9.4%), 101 Catholics (18.2%), and 321 patients belonging to other religious groups (57.7%). Mean Injury Severity Scores for 433 patients were 10.3 ± 9, 8.9 ± 10, 10.3 ± 11, and 11.3 ± 14, respectively. There were no significant differences in mean Injury Severity Scores between religious groups, and no statistically significant associations between religion and Injury Severity Scores were identified. Significant predictors of mortality were age, systolic blood pressure at admission, Glasgow Coma Scale score, and type of trauma. Jehovah's Witnesses were 6% more likely to die after major trauma than Baptists, 20% more likely than Catholics, and as likely as patients from any other religious groups.

Conclusion:
After controlling for age, race, systolic blood pressure, Glasgow Coma Scale score, and type of trauma, Jehovah's Witnesses have a nonsignificant increased risk of death after major trauma compared with other religious groups.

Key Words: Jehovah's Witnesses; Risk of death; Major trauma
Submitted for publication October 5, 2001.
Accepted for publication November 4, 2002.

From the Departments of Surgery (J.E.V., S.M.C.) and Epidemiology and Public Health (O.G.-M., L.E.F.), University of Miami School of Medicine, Miami, Florida.

Presented at the 87th American College of Surgeons Clinical Congress Surgical Forum, October 10, 2001, New Orleans, Louisiana.

Address for reprints: J. Esteban Varela, MD, MPH, Department of Surgery (M/C 958), University of Illinois at Chicago, 840 South Wood Street, Chicago, IL 60612-7322; email: varela@uic.edu.