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Interaction Between Neighborhood Poverty Rate and Outcome Following Burn Injury: A Multicenter Study
Anaeze Offodile II, MD, Kenneth Christopher, MD
Brigham and Women's Hospital, Boston, MA
Background: The incidence of burn is higher in lower socioeconomic (SES) groups. It is not clear if SES alters the mortality in patients with burn injury. We hypothesized that low SES would increase the burn associated mortality risk
Methods: We performed a retrospective cohort study of 471 burn patients, admitted to two Boston hospitals over 10 years. Data sources included inpatient records and the US Census. The exposure of interest was %TBSA burn characterized as minor <15%, moderate 15-25% or critical > 25%. Neighborhood Poverty rate, a proxy for SES, was categorized as ?10% or >10% of residents below the poverty line. The primary end point was all cause mortality after 30 days. Associations between %TBSA burn and mortality were estimated by logistic regression models.
Results: The average age was 47.5 years and mean %TBSA was 24.2%. The 30-day mortality was 10.6%, with an average LOS of 26.7 days. There was a significant adjusted association between %TBSA and mortality (OR 15-25% was 2.91; and OR >25% was 23.70). The association between %TBSA and mortality was not modified by SES (p=0.37). There was a non significant adjusted association between low SES and mortality outcomes (p=0.2). Length of stay had a significant adjusted association with % TBSA and not with SES. Associations were appropriated adjusted for patient baseline characteristics.
Conclusion: In our primarily urban and suburban cohort, patients with low SES and burn injuries are not at greater risk of mortality and do not require longer durations of total hospitalization
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