社区层面的差异在吸入伤害患者群体
Christopher J Fedor1, Mare G Kaulakis1, Hilary Y Liu1
1University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, PA, United States.
概括
由于火灾造成的吸入伤害不成比例地影响社会脆弱的社区. 虽然急性护理的提供似乎是公平的,但更高的社会脆弱性独立地预测了死亡风险的增加.
科学领域:
- 烧伤研究 烧伤研究
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
背景情况:
- 低收入社区的火灾风险和烧伤严重程度较高.
- 吸入伤害很常见,通常需要输管和专业护理.
- 社区层面的因素,如社会脆弱性和城市化,可能会影响获得护理的机会.
研究的目的:
- 检查吸入伤害的管理策略和临床结果如何因社会脆弱性和城市化而有所不同.
- 根据社区层面的因素,识别护理和结果的差异.
主要方法:
- 对184名因建筑火灾而受到吸入伤害的患者 (2012-2024) 的回顾性审查.
- 在一个单一的烧伤中心通过支气管镜诊断的吸入伤害.
- 用社会脆弱性指数 (SVI) 评估社区的脆弱性;用RUCA代码评估城市化.
主要成果:
- 更高的社会脆弱性与更多的黑人个人和更高的喘患病率有关.
- 在SVI/城市群体中,烧伤严重程度,输管时间或住院时间没有显著差异.
- 农村居民更有可能从外面的医院转移到现场并被直管.
- 高社会脆弱性独立预测死亡风险增加,但不是ARDS或肺炎.
结论:
- 大多数吸入伤害患者来自社会脆弱的社区.
- 当资源可用时,急性护理的提供似乎在脆弱程度上是公平的.
- 更高的社会脆弱性与死亡率的增加有关,突出了关键的结果差异.
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