Related Experiment Videos

Race/Ethnicity is not associated with mortality in the PICU

David Epstein1, Carolyn F Wong, Robinder G Khemani

  • 1Children's Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, 4650 Sunset Blvd, MS #3, Los Angeles, CA 90027, USA. depstein@chla.usc.edu

Pediatrics
|March 2, 2011
PubMed

Insights

Pediatric intensive care unit (PICU) survival is not significantly impacted by race/ethnicity after adjusting for illness severity. Other factors like age, gender, and diagnosis influence PICU mortality, warranting further investigation into socioeconomic influences.

Area of Science:

  • Pediatric critical care medicine
  • Health services research
  • Epidemiology

Background:

  • Racial and ethnic disparities in healthcare outcomes are a significant concern.
  • Understanding survival differences in pediatric intensive care units (PICUs) is crucial for improving care.
  • Previous studies have suggested racial/ethnic variations in pediatric healthcare, but controlling for illness severity is key.

Purpose of the Study:

  • To investigate whether racial or ethnic background is associated with survival differences among children admitted to the PICU.
  • To adjust for the severity of illness using the pediatric index of mortality 2 (PIM2) when examining PICU survival rates.
  • To identify risk factors for mortality in the PICU population across different demographic groups.

Main Methods:

  • Utilized a large national clinical PICU database (Virtual PICU Performance System) encompassing data from 31 hospitals (2005-2008).
  • Included pediatric patients (18 years and younger) and collected demographic, PIM2, diagnosis, and PICU mortality data.
  • Employed logistic regression models to analyze PICU mortality risk factors, controlling for illness severity.

Main Results:

  • Analysis of 80,739 patients indicated that female gender, age (1 month or younger, 12 years or older), and specific diagnoses (infectious, oncologic) were associated with increased PICU mortality, even after adjusting for PIM2.
  • Initial findings suggested "other" insurance type and Asian/Indian/Pacific Islander race/ethnicity as potential mortality risk factors, but these were deemed inconclusive due to heterogeneity and small sample sizes.
  • The study found no statistically significant association between race/ethnicity and PICU mortality after controlling for illness severity.

Conclusions:

  • Gender, age, and diagnosis significantly impact PICU mortality, independent of illness severity.
  • Race/ethnicity was not found to be an independent risk factor for PICU mortality in this cohort.
  • Further research is recommended to explore the role of unmeasured variables, such as sociocultural and socioeconomic factors, which may be indirectly indicated by insurance type.
Abstract

Related Concept Videos

Changes in Skin Color: Clinical Perspectives01:14

Changes in Skin Color: Clinical Perspectives

The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Stereotypes, Prejudice, and Discrimination02:55

Stereotypes, Prejudice, and Discrimination

Humans are very diverse and although we share many similarities, we also have many differences. The social groups we belong to help form our identities (Tajfel, 1974). These differences may be difficult for some people to reconcile, which may lead to prejudice toward people who are different. Prejudice is a negative attitude and feeling toward an individual based solely on one’s membership in a particular social group (Allport, 1954; Brown, 2010). Prejudice is common against people who are...
Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...
Bias in Epidemiological Studies01:29

Bias in Epidemiological Studies

Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
Ethnic Identity within a Larger Culture01:27

Ethnic Identity within a Larger Culture

Adolescents from ethnic minority backgrounds face a multifaceted journey in forming their identities, shaped by the intersections of cultural expectations and personal exploration. For these adolescents, identity formation involves not only typical developmental challenges but also navigating the perceptions and attitudes of the majority culture. As they grow, adolescents in ethnic minority groups often become increasingly aware of stereotypes, social biases, and discrimination, all of which...
Surveys02:16

Surveys

Often, psychologists develop surveys as a means of gathering data. Surveys are lists of questions to be answered by research participants, and can be delivered as paper-and-pencil questionnaires, administered electronically, or conducted verbally. Generally, the survey itself can be completed in a short time, and the ease of administering a survey makes it easy to collect data from a large number of people.