Researchers ‘Surprised’ that Unlike Whites, Race Actually Protects Young Black Adults from Becoming Delirious in ICUs

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Younger African-American adults are less likely to become severely confused during their stays in hospital intensive care units, a new study suggests.

Researchers at the Regenstrief Institute in Indiana found that Black ICU patients aged 18 to 50 were less vulnerable to delirium than whites of the same age, in the first study to examine the connection between race and intensive treatment-induced delirium.

Delirium is a sudden acute state of mental imbalance, most often characterized by confusion and a general lack of awareness. The condition is a symptom of a larger issue, such as pneumonia, urinary tract infection, or recent surgery, all common in hospital patients. Some sufferers become hyperagressive and agitated, while others grow fatigued and listless.

Scientists studied 2,087 adults — 48 percent of them African-American — admitted to medical or surgical units at Eskenazi Health, an Indianapolis health care system serving mostly socioeconomically disadvantaged residents in Marion County. The majority of patients in the study were uninsured or covered by state Medicaid programs, and therefore shared comparable economic characteristics.

Regenstrief Medical database records showed Black and white patients had similar rates of dementia diagnoses, severity of illness, deaths and mechanical ventilator usage. Whites were prescribed delirium medications more often than Blacks and were more likely to smoke or be diagnosed with depression.

“Since African-Americans tend to have higher disease severity in the ICU, we were surprised to find that race could be a protective factor for younger African-American adults,” Babar A. Khan, research scientist at the Indiana University Center for Aging and lead author of the study said in the Institute’s press release.

“We now know that race should be considered among the risk factors for developing delirium for Caucasians of all ages but only for African-Americans if they are 50 or older. Clearly, different groups have different risk profiles for delirium.”

Khan said that while the National Institute on Aging-funded study could not explain the lower rates of delirium in younger African-American adults, the findings could inform doctors’ treatment practices for different ethnic groups.

“Relationship between African-American Race and Delirium in the Intensive Care Unit” is published in the Critical Care Medicine journal.

The study is a silver lining for a population used to more somber news on health disparities.

Black Americans have a greater risk of developing cardiovascular disease, diabetes and kidney disorders among other chronic conditions.

The delirium study shows that some biological differences can be an advantage to Black patients.

“If you look at various studies, there are certain medications to which African-Americans respond better and from which they have better outcomes compared to Caucasians,” Dr. Khan said. “If in the near future we are able to learn more about delirium at a basic or molecular level utilizing genetics and biomarkers, we may be able to come up with better preventive and treatment strategies based on personalization of therapy. Our findings provide the kind of information we need to conduct precision medicine.”

Atlanta Black Star highlighted a recent Veterans Affairs study, which found that when Black and white patients get the same level of treatment, not only do racial disparities disappear, Black patients seem to do better.

A genetic study released earlier this month found that West African ancestry protects Black American males against obesity.

Waist circumference and waist-hip ratios tend to be lower in African-American men with a higher concentration of West African genes, meaning they have less of the dangerous belly fat that leads to heart disease and insulin resistance.

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