Division of Pediatric Surgery, Department of Surgery, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
Department of Surgery, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
Burns. 2024 Aug;50(6):1487-1493. doi: 10.1016/j.burns.2024.03.035. Epub 2024 Apr 4.
Pediatric burns are associated with socioeconomic disadvantage and lead to significant morbidity. The Child Opportunity Index (COI) is a well-validated measure of neighborhood characteristics associated with healthy child development. We sought to evaluate the relationship between COI and outcomes of burn injuries in children.
We performed a single-institution retrospective review of pediatric (<16 years) burn admissions between 2015 and 2019. Based on United States residential zip codes, patients were stratified into national COI quintiles. We performed a multivariate Poisson regression analysis to determine the association between COI and increased length of stay.
2095 pediatric burn admissions occurred over the study period. Most children admitted were from very low (n = 644, 33.2 %) and low (n = 566, 29.2 %) COI neighborhoods. The proportion of non-Hispanic Black patients was significantly higher in neighborhoods with very low (44.5 %) compared to others (low:28.8 % vs. moderate:11.9 % vs. high:10.5 % vs. very high:4.3 %) (p < 0.01). Hospital length of stay was significantly longer in patients from very low COI neighborhoods (3.6 ± 4.1 vs. 3.2 ± 4.9 vs. 3.3 ± 4.8 vs. 2.8 ± 3.5 vs. 3.2 ± 8.1) (p = 0.02). On multivariate regression analysis, living in very high COI neighborhoods was associated with significantly decreased hospital length of stay (IRR: 0.51; 95 % CI: 0.45-0.56).
Children from neighborhoods with significant socioeconomic disadvantage, as measured by the Child Opportunity Index, had a significantly higher incidence of burn injuries resulting in hospital admissions and longer hospital length of stay. Public health interventions focused on neighborhood-level drivers of childhood development are needed to decrease the incidence and reduce hospital costs in pediatric burns.
Retrospective study LEVEL OF EVIDENCE: Level III.
儿科烧伤与社会经济劣势有关，会导致严重的发病率。儿童机会指数（COI）是一种经过充分验证的衡量与儿童健康发展相关的邻里特征的指标。我们试图评估 COI 与儿童烧伤结果之间的关系。
我们对 2015 年至 2019 年期间的儿科（<16 岁）烧伤住院患者进行了单机构回顾性研究。根据美国居住的邮政编码，患者被分为国家 COI 五分位数。我们进行了多变量泊松回归分析，以确定 COI 与住院时间延长之间的关联。
研究期间发生了 2095 例儿科烧伤住院。大多数入院的儿童来自非常低（n=644，33.2%）和低（n=566，29.2%）COI 社区。非常低 COI 社区的非西班牙裔黑人患者比例明显高于其他社区（低：28.8%比中：11.9%比高：10.5%比非常高：4.3%）（p<0.01）。来自非常低 COI 社区的患者的住院时间明显更长（3.6±4.1 vs. 3.2±4.9 vs. 3.3±4.8 vs. 2.8±3.5 vs. 3.2±8.1）（p=0.02）。多元回归分析显示，生活在非常高 COI 社区与住院时间明显缩短相关（IRR：0.51；95%CI：0.45-0.56）。
以儿童机会指数衡量的社会经济劣势较大的社区的儿童烧伤发病率显著较高，导致烧伤住院和住院时间延长。需要针对儿童发展的邻里驱动因素开展公共卫生干预措施，以降低儿科烧伤的发病率并降低医院成本。
回顾性研究 证据水平：III 级
