不平等愈合：烧伤后增生性瘢痕的种族差异。

IF 2.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the National Medical Association Pub Date : 2025-07-24 DOI:10.1016/j.jnma.2025.07.004

Derek Nuamah , Jarrell B. Patterson , Joshua E. Lewis , Ertha Sefu Omba , Olivia Anga , Blanche Neige , Raven J. Hollis , Ernst Nicarnord

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引用次数: 0

摘要

摘要：增生性瘢痕形成是烧伤的常见并发症，其发生率和治疗结果因种族而异。这项研究的动机是进一步了解在不同种族群体之间存在的增生性疤痕形成的差异。本研究旨在通过调查非裔美国人、亚裔和白人患者烧伤一年后增生性瘢痕形成的差异来解决这一差距。方法：我们使用TriNetX研究网络进行了一项回顾性队列研究，该网络是截至2024年8月28日112个医疗保健组织（hco）超过1.16亿患者的去身份化电子健康记录的联邦数据库。患者按种族分层。根据年龄、性别和烧伤严重程度调整倾向评分匹配。在1个月、6个月和12个月时评估增生性疤痕。以白人患者作为参考队列计算相对风险比。结果：我们确定了2013年至2023年间治疗的633,708例成人烧伤患者（≥18岁）。非裔美国人、亚洲人和夏威夷原住民患者与白人患者相比，增生性瘢痕形成的风险明显更高（p ）。结论：烧伤后增生性瘢痕形成的发生率存在显著的种族差异。与白人患者相比，非裔美国人、亚洲人和夏威夷原住民患者的风险更高。需要进一步研究，为高危患者群体制定公平的预防和治疗战略。

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Unequal healing: Racial differences in hypertrophic scarring following burn injuries

Introduction

Hypertrophic scarring is a common complication of burn injuries, and its incidence and treatment outcomes vary among racial groups. The motivation for this study was to further understand the disparities in hypertrophic scar formation that exist amongst different racial groups. This study aimed to address the gaps by investigating disparities in hypertrophic scar formation among African American, Asian, and White patients one year after burn injury.

Methods

We conducted a retrospective cohort study using the TriNetX Research Network, a federated database of de-identified electronic health records from over 116 million patients across 112 healthcare organizations (HCOs) as of August 28, 2024. Patients were stratified by race. Propensity score matching adjusted for age, gender, and burn severity. Hypertrophic scarring was assessed at one, six, and twelve months. Relative risk ratio was calculated using White patients as the reference cohort. Statistical significance was deemed p < 0.05.

Results

We identified 633,708 adult burn patients (≥18 years) treated between 2013 and 2023. African American, Asian, and Native Hawaiian patients had significantly higher risks of hypertrophic scarring compared to White patients (p < 0.05). At six months and one-year, similar trends persisted across racial groups. Among the 46,893 patients with hypertrophic scarring, 63.06 % were White, 13.50 % Black, 2.47 % Asian, 0.55 % Native Hawaiian, and 0.54 % American Indian. Interestingly, Native Hawaiians demonstrated a decreased risk in specific subgroup analyses (p < 0.05).

Conclusion

Significant racial disparities exist in hypertrophic scarring incidence following burn injury. African American, Asian, and Native Hawaiian patients are at elevated risk compared to White patients. Further research is needed to develop equitable prevention and treatment strategies for high-risk patient populations.

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来源期刊

Journal of the National Medical Association 医学-医学：内科

CiteScore

4.80

自引率

3.00%

发文量

139

审稿时长

98 days

期刊介绍： Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.