Clark Rachael A, Garcia Isabel C, Jacobson Jillian C, Chung Dai H
Department of Surgery, Division of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Children (Basel). 2022 Sep 21;9(10):1428. doi: 10.3390/children9101428.
(1) Background: Significant racial and ethnic disparities affect access to pediatric Emergency Department (ED) and surgical care across the United States. The present study sought to assess the role of racial and ethnic disparities in the management of pediatric subcutaneous abscesses. (2) Methods: A retrospective chart review was performed including ED visits for subcutaneous abscesses in patients < 18 years of age, over a 12-month period. The effects of self-reported ethnicity (Hispanic versus non-Hispanic) and race (Hispanic, Black, Caucasian and Asian) on the diagnosis and management of subcutaneous abscesses were analyzed. (3) Results: 192 patients were identified with an average age of 4.7 ± 5.3 years and 43.8% identified as Hispanic. Non-Hispanic patients were significantly more likely to receive treatment of their SSTI prior to the ED and to be admitted, compared to Hispanic patients. There was no difference in bedside versus operating room incision and drainage (I&D); however, significantly more non-Hispanic patients received procedural sedation for bedside I&D compared to Hispanic patients. There were no differences in outcomes such as recurrence or re-admission based on ethnicity or race. (4) Conclusions: Ethnic and racial disparities exist in the management of subcutaneous abscesses in the United States. Further studies are needed to address the systemic causes of these disparities such as access to tertiary healthcare facilities and systems-based analyses of unconscious bias in healthcare.
(1) 背景：显著的种族和民族差异影响着美国各地儿童急诊科（ED）就诊及手术治疗的可及性。本研究旨在评估种族和民族差异在儿童皮下脓肿治疗中的作用。(2) 方法：进行了一项回顾性病历审查，纳入18岁以下患者在12个月期间因皮下脓肿到急诊科就诊的情况。分析了自我报告的种族（西班牙裔与非西班牙裔）和民族（西班牙裔、黑人、白种人和亚洲人）对皮下脓肿诊断和治疗的影响。(3) 结果：共识别出192例患者，平均年龄4.7±5.3岁，43.8%为西班牙裔。与西班牙裔患者相比，非西班牙裔患者在急诊科就诊前接受皮肤和软组织感染（SSTI）治疗及住院的可能性显著更高。床旁切开引流与手术室切开引流（I&D）无差异；然而，与西班牙裔患者相比，显著更多的非西班牙裔患者在床旁I&D时接受了程序性镇静。基于种族或民族的复发或再次入院等结局无差异。(4) 结论：美国在皮下脓肿治疗方面存在种族和民族差异。需要进一步研究以解决这些差异的系统性原因，如获得三级医疗设施的机会以及对医疗保健中无意识偏见的基于系统的分析。
