Savage, Beth. Race as a fundamental cause of disparities in the consequences of infection in children with leukemia. Retrieved from https://doi.org/doi:10.7282/t3-mmt5-2551
DescriptionDespite gains in overall survival following the diagnosis of leukemia, disparities persist between children belonging to White and non-White racial groups. Infectious complications are the second leading cause of death after the leukemia itself, yet few studies have sought to determine if there are racial differences in these complications that can explain some of the disparities that exist. The purpose of this study was to investigate race as a risk factor for infectious complications in hospitalized children, and when infection is present, if there are racial differences in the progression to severe sepsis and utilization of healthcare resources.
This was a secondary analysis of cross-sectional data compiled from the 2016 Healthcare Cost and Utilization Project Kids’ Inpatient Database that tested hypotheses guided by the conceptual framework of the Fundamental Cause Theory. There were two separate samples analyzed representing the common forms of childhood leukemia: the sample of lymphoblastic leukemia consisted of 28914 cases, and the sample of acute myeloid leukemia consisted of 2902 cases. Each case represented a pediatric hospitalization that took place in the United States in the year 2016. Logistic regression analyses revealed the risk for severe sepsis in Hispanic children was significantly greater than that of White children in both the acute lymphoid leukemia and the acute myeloid leukemia groups. Asian and Black children with acute lymphoid leukemia were found to be at significantly increased risk for high-cost hospitalizations, compared to White children.
This study provided evidence that the occurrence of life-threatening infections in hospitalized children with leukemia is a potential contributor to the disparate rates of survival and worthy of further investigation. Additional research should be conducted with the goal of developing an explanatory model for these disparities that can be used to improve nursing care of this vulnerable population.