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在国家支气管扩张和非结核分枝杆菌研究注册中心注册的患者中存在种族和民族差异。

Racial and ethnic differences in patients enrolled in the national bronchiectasis and nontuberculous mycobacteria research registry.

机构信息

University of Texas Health Science Center at Tyler, Tyler, TX, USA.

Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.

出版信息

Respir Med. 2023 Apr;209:107167. doi: 10.1016/j.rmed.2023.107167. Epub 2023 Feb 16.

Abstract

Demographic and socioeconomic factors are recognized to contribute to disparities in healthcare outcomes. Originally, bronchiectasis was described in a population of predominantly White ethnic group of patients in which racial disparity could not be identified. The U.S. Bronchiectasis Research Registry (BRR), a centralized database of adult patients with bronchiectasis and/or NTM from 18 clinical institutions across the U.S., was created to support the research of this condition. The aim of this study is to describe the racial and ethnic distribution of patients enrolled in the BRR and evaluate factors associated with healthcare disparities within manifestations of and/or the care delivered to this population. At the time of this study, 3600 patients with bronchiectasis and/or NTM were enrolled in the BRR. Of those, 3510 participants were included in these analyses. The population was predominantly non-HispanicWhite (n = 3143, 89.5%), followed by Hispanic or Latino (n = 149, 4.3%), Asian (n = 130, 3.7%) and non-Hispanic Black (n = 88, 2.5%) participants. Testing for cystic fibrosis, immunoglobulin deficiency, and mycobacteria was not different between races, but non-Hispanic Black patients were tested less frequently for alpha-1 antitrypsin (A1AT) deficiency compared to other groups (P = 0.01). The four groups did not differ in the proportion of Pseudomonas aeruginosa or Hemophilus influenzae. There was no statistically significant difference in use of high-frequency chest wall oscillation, pulmonary rehabilitation services, or suppressive macrolide treatment across the groups (P > 0.05). There is a disproportionately high percentage of non-Hispainc White patients compared to non-Hispanic Black patients and Hispanic or Latino patients in the BRR. However, we found an overall similarity of care of BRR patients, regardless of racial and ethnic group.

摘要

人口统计学和社会经济因素被认为是导致医疗保健结果差异的原因。最初,支气管扩张症主要在白种人群中描述,种族差异无法确定。美国支气管扩张症研究登记处(BRR)是一个集中的数据库,包含来自美国 18 个临床机构的支气管扩张症和/或非结核分枝杆菌成年患者,旨在支持对这种疾病的研究。本研究的目的是描述 BRR 中患者的种族和民族分布,并评估与该人群的临床表现和/或护理相关的医疗保健差异的相关因素。在本研究时,BRR 共登记了 3600 例支气管扩张症和/或非结核分枝杆菌患者。其中,3510 名参与者被纳入这些分析。该人群主要是非西班牙裔白人(n=3143,89.5%),其次是西班牙裔或拉丁裔(n=149,4.3%)、亚洲人(n=130,3.7%)和非西班牙裔黑人(n=88,2.5%)。对囊性纤维化、免疫球蛋白缺乏症和分枝杆菌的检测在不同种族之间没有差异,但与其他组相比,非西班牙裔黑人患者接受α-1 抗胰蛋白酶(A1AT)缺乏症检测的频率较低(P=0.01)。四组人群中铜绿假单胞菌或流感嗜血杆菌的比例没有差异。各组之间高频胸壁振荡、肺康复服务或抑制性大环内酯类药物治疗的使用没有统计学差异(P>0.05)。BRR 中与非西班牙裔黑人患者和西班牙裔或拉丁裔患者相比,非西班牙裔白人患者的比例不成比例地高。然而,我们发现无论种族和民族群体如何,BRR 患者的护理总体上相似。

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