State University of New Jersey, Newark, NJ, USA.
Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
J Pediatr Oncol Nurs. 2020 Nov/Dec;37(6):349-358. doi: 10.1177/1043454220919699. Epub 2020 May 22.
The purpose of this study, a secondary analysis of a publicly available database, was to identify racial and ethnic disparities in the risk of severe sepsis facing children undergoing the intensive therapy necessary to treat acute myeloid leukemia (AML). The sample consisted of 1,913 hospitalizations of children, younger than 21 years, in the United States during the year 2016 with documentation of both AML and at least one infectious complication. Binary logistic regression models were used to examine the association between race/ethnicity and severe sepsis in children with AML and infection. We found that, after controlling for potential confounding variables, the odds of developing severe sepsis were significantly increased for Hispanic children compared with White children. There were no significant differences in the likelihood of the development of sepsis in Black, Asian, or other race children. The increased risk of severe sepsis for Hispanic children may contribute to the disparate rates of overall survival in this group. This inequitable rate of severe sepsis was evident despite the generally accepted practice of retaining children in the hospital throughout recovery of blood counts following AML therapy. Nurses are in a position to identify and eliminate modifiable risk factors contributing to this disparity.
本研究旨在对一个公开数据库进行二次分析，以确定在接受治疗急性髓细胞白血病（AML）所需的强化治疗的儿童中，严重脓毒症的风险存在种族和民族差异。该样本包括 2016 年美国 1913 名年龄在 21 岁以下的儿童住院治疗，其记录有 AML 和至少一种感染并发症。使用二元逻辑回归模型来检查 AML 和感染儿童的种族/民族与严重脓毒症之间的关联。我们发现，在控制了潜在的混杂变量后，与白人儿童相比，西班牙裔儿童发生严重脓毒症的几率显著增加。黑人、亚洲或其他种族的儿童发生脓毒症的可能性没有显著差异。西班牙裔儿童发生严重脓毒症的风险增加可能导致该人群的总体生存率存在差异。尽管普遍接受的做法是在 AML 治疗后，让儿童在医院内等待血细胞计数恢复，但这种严重脓毒症的不平等发生率仍然存在。护士有能力识别和消除导致这种差异的可改变的风险因素。
