Racial And Socioeconomic Differences Affect Outcomes in Elderly Burn Patients

Kathleen S. Romanowski; Yunshu Zhou; Patrick Ten Eyck; Anthony Baldea; James J. Gallagher; Colette Galet; Yuk Ming Liu

doi:10.1016/j.burns.2020.10.025

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Racial And Socioeconomic Differences Affect Outcomes in Elderly Burn Patients

Journal article

Peer reviewed

Racial And Socioeconomic Differences Affect Outcomes in Elderly Burn Patients

Kathleen S. Romanowski, Yunshu Zhou, Patrick Ten Eyck, Anthony Baldea, James J. Gallagher, Colette Galet and Yuk Ming Liu

BURNS, Vol.47(5), pp.1177-1182

08/01/2021

DOI: 10.1016/j.burns.2020.10.025

PMID: 33933303

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Abstract

Background: Race and socioeconomic status influence outcomes for adult and pediatric burn patients, yet the impact of these factors on elderly patients (Medicare eligible, 65 years of age) remains unknown. Methods: Data pooled from three verified burn centers from 2004 to 2014 were reviewed retrospectively. Age, race, gender, percent total body surface area (%TBSA) burn, mortality, length of stay (LOS), LOS per %TBSA burn, and zip code which provided Census data on race, poverty, and education levels within a community were collected. Data were analyzed using logistic and generalized linear models in SAS version 9.4 (SAS Institute, Cary, NC, USA). Results: Our population was mainly Caucasian (63%), African American (18%), Hispanic (7.6%), and Asian (3.5%). Mean age was 76.3 +/- 8.3 years, 52.5% were male. Mean %TBSA was 9 +/- 13.8%; 15% of the patients sustained an inhalation injury. The mortality rate was 14.4%. Inhalation injury was significantly associated with mortality and discharge to a skilled nursing facility (SNF) (p < 0.05). Race was significantly associated with socioeconomic disparities and affected LOS/TBSA, but not discharge to SNF or mortality on univariate analysis. Poverty level, education level, and insurance status (others vs. public) independently predicted SNF discharge, while median income and insurance type independently predicted LOS/TBSA. Conclusion: In this elderly cohort, race did not predict standard markers of burn outcome (mortality and discharge to SNF). Socioeconomic status independently predicted LOS and discharge to SNF, suggesting a relationship between socioeconomic status and recovery from a burn injury. Better understanding of racial and socioeconomic disparities is necessary to provide equitable treatment of all patients. (c) 2020 Published by Elsevier Ltd.

Critical Care Medicine

Dermatology

General & Internal Medicine

Life Sciences & Biomedicine

Science & Technology

Surgery

Details

Title: Subtitle: Racial And Socioeconomic Differences Affect Outcomes in Elderly Burn Patients
Creators: Kathleen S. Romanowski - University of Iowa
Yunshu Zhou - University of Iowa
Patrick Ten Eyck - Univ Iowa, Inst Clin & Translat Sci, Iowa City, IA USA
Anthony Baldea - Loyola University Chicago
James J. Gallagher - Weill Cornell Medicine
Colette Galet - University of Iowa
Yuk Ming Liu - University of Iowa
Resource Type: Journal article
Publication Details: BURNS, Vol.47(5), pp.1177-1182
DOI: 10.1016/j.burns.2020.10.025
PMID: 33933303
NLM abbreviation: Burns
ISSN: 0305-4179
eISSN: 1879-1409
Publisher: Elsevier
Number of pages: 6
Grant note: UL1TR002537 / University of Iowa Clinical and Translational Science Award-NIH UL1 TR001860 / National Center for Advancing Translational Sciences, National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
Language: English
Date published: 08/01/2021
Academic Unit: Biostatistics; Injury Prevention Research Center; University of Iowa Health Care; Design Biostat and Ethics
Record Identifier: 9985138031902771

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