Racial and Ethnic Disparities in Complications Following Pediatric Burn Injuries.

Abstract

Pediatric burn injuries are common and carry a high rate of morbidity. Given the well-established literature on racial and ethnic disparities in healthcare, we sought to define the extent to which these disparities exist in complications following burn injury in pediatric patients. We reviewed the American Burn Association's (ABA) National Burn Repository (NBR) data from 2010-2018. Demographic data, burn mechanism and severity, complications, and clinical outcomes were recorded. Analysis included 1:1 propensity-score-matching and logistic regression. Among 67,837 children aged 0-14 years, racial distribution was as follows: 44.7% white, 28.2% black, 3.4% Asian, and 23.8% other. Scald injuries were the most common cause of burns across all races (52.6%). All comparisons were made in reference to the white population. Black patients had higher mortality (aOR: 1.80, 95%CI: 1.23-2.64) and black and other patients were more likely to sustain any complication (aOR: 1.25, 95%CI: 1.12-1.41; aOR: 1.28, 95%CI: 1.15-1.43, respectively). Black, Asian, and other patients were more likely to sustain electrolyte/other complications (aOR: 1.86, 95%CI: 1.42-2.43; aOR: 2.66, 95%CI: 1.28-5.54; aOR: 1.47, 95%CI: 1.15-1.87, respectively). Black, Asian, and other patients had longer length of hospital stay (aOR: 1.15, 95%CI: 1.09-1.21; aOR: 1.49, 95%CI: 1.29-1.72; aOR: 1.58 95%CI: 1.50-1.66, respectively). These data show ongoing disparities in the clinical outcomes of pediatric burn patients. These findings highlight the need for further work to determine the etiology of these inequalities and to improve burn care for all children.