A Comparison of Racial and Ethnic Disparities in Complications Following Burn Injury in Adult Patients

Abstract

Abstract Burn injury contributes to significant morbidity and mortality in the United States. Despite an increased focus on racial and ethnic disparities in healthcare, there remains a critical knowledge gap in our understanding of the effect of these disparities on complications experienced by burn patients. The American Burn Association’s National Burn Repository data were reviewed from 2010 to 2018. Information regarding demographics, burn mechanism and severity, complications, and clinical outcomes were recorded. Data analysis was performed using 1:1 propensity score matching and logistic regression modeling. A separate analysis of Hispanic and non-Hispanic patients was performed using Chi-squared tests. Among 215,071 patients, racial distribution was 65.16% White, 19.13% Black, 2.18% Asian, 0.74% American Indian/Alaskan Native, and 12.78% other. Flame injuries were the most common cause (35.2%), followed by scald burns (23.3%). All comparisons were made in reference to the White population. Black patients were more likely to die (OR: 1.28; 95% CI, 1.17-1.40), experience all (OR: 1.08; 95% CI, 1.03-1.14), cardiovascular (OR: 1.24; 95% CI, 1.08-1.43), or infectious (OR: 1.64; 95% CI, 1.40-1.91) complications, and less likely to experience airway complications (OR: 0.83; 95% CI, 0.74-0.94). American Indian/Alaskan Native patients were more likely to experience any complication (OR: 1.33; 95% CI, 1.05-1.70). All minority groups had increased length of hospital stay. Black, Asian, and other patients had longer length of ICU stay. Black patients had longer ventilator duration. Among 82 775 patients, 24 075 patients were identified as Hispanic and 58 700 as non-Hispanic. Statistically significant differences were noted between groups in age, total body surface area, proportion of 2nd-degree burn, and proportion of 3rd-degree burn (P < .01). These findings highlight the need for further work to determine the etiology of these disparities to improve burn care for all patients.