A Cross-Sectional Analysis of Pediatric Necrotizing Soft Tissue Infection Cases and Racial Disparities From the 2016 to 2020 National Inpatient Sample

Authors

Safraz A. Hamid, Department of Surgery, Yale School of Medicine, New Haven, Connecticut. Electronic address: safraz.hamid@yale.edu.
Elena Graetz, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.Follow
Eric Schneider, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.Follow
Karen E. Gibbs, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.Follow

Document Type

Article

Publication Title

The Journal of surgical research

Abstract

INTRODUCTION: The incidence, treatment, and outcomes of necrotizing soft tissue infections (NSTIs) and associated racial disparities have been described in adults, but research in the pediatric population is limited. The purpose of this study is to provide a nationally representative characterization of pediatric NSTI and determine the presence of any racial disparities. METHODS: The National Inpatient Sample was analyzed from 2016 through 2020. Patients aged less than 20 y with a diagnosis of necrotizing fasciitis, Fournier's gangrene, or gas gangrene (based on International Classification of Diseases, Tenth Revision, Clinical Modification codes) were included for analysis. RESULTS: A total of 355 patients were identified. Black and Hispanic patients accounted for the most admissions in 2016 and 2018, respectively (P = 0.024). Compared to White patients, more Black patients were insured by Medicaid (P = 0.037) and were in the first zip code-based income quartile (P = 0.005). The leading infection overall was necrotizing fasciitis and most patients (81.7%) underwent a surgical procedure by the first calendar day after admission. Although the proportion of Black patients undergoing subcutaneous tissue and fascia excisions was more than that of White patients (P = 0.005), there were no significant differences by race in the time to first procedure, the total number of procedures, or number of postoperative complications. Our amputation and mortality rates were low and unreportable, but there were no differences by race. CONCLUSIONS: NSTI is rare in the pediatric population and mortality is low. Black patients are disproportionately diagnosed, but these disparities do not extend to disease treatment or outcomes.

First Page

136

Last Page

143

DOI

10.1016/j.jss.2024.02.009

Publication Date

5-1-2024

Recommended Citation

Hamid, Safraz A.; Graetz, Elena; Schneider, Eric; and Gibbs, Karen E., "A Cross-Sectional Analysis of Pediatric Necrotizing Soft Tissue Infection Cases and Racial Disparities From the 2016 to 2020 National Inpatient Sample" (2024). Surgery. 149.
https://scholar.bridgeporthospital.org/surgery/149

Identifier

38518580 (pubmed); 10.1016/j.jss.2024.02.009 (doi); S0022-4804(24)00089-1 (pii)