Abstract
Abstract Introduction Racial and ethnic minority patients may experience worse hypertrophic scar after burn injury than Non-Hispanic, White patients. Consequently, they may encounter differences in scar-related recovery domains including itch and fatigue. We examined disparities in post-burn injury itch and fatigue in minority patients to better inform counseling and treatment considerations. Methods From the multicenter National Institute of Disability, Independent Living and Rehabilitation Research Burn Model System Database (2015-2019), we analyzed outcomes at three time-points (discharge from index hospitalization, 6- and 12-months post-injury) using the 5-D Itch and PROMIS-29 Fatigue measures. Multi-level linear mixed effects regression modeling analyzed associations between race/ethnicities and outcomes over time. Results Of 893 total patients, 149 (17%) patients were Hispanic/Latino, 603 (68%) Non-Hispanic, White, and 86 (10%) Black. Minority patients reported higher/worse itch scores at all time points compared to Non-Hispanic, White patients. Itch scores were significantly higher for Black patients at 6 months (β=1.42, p=0.03) and 12 months (β=3.36, p< 0.0001) when compared to Non-Hispanic, White patients. Black patients reported higher fatigue scores than Non-Hispanic, White patients at all time points. Fatigue scores were significantly higher for Hispanic/Latino patients at discharge (β=6.17, p< 0.0001), 6 months (β=4.49, p=0.0003), and 12 months (β=6.27, p< 0.0001) than Non-Hispanic, White patients. Conclusions This study supports investigation of potential factors leading to increased itch and fatigue such as genomic scar differences, relative treatment effects (e.g., medications, cognitive processing therapy), and psychosocial impacts of these symptoms. Applicability of Research to Practice In the short-term, minority patients may benefit from additional counseling and focused treatments addressing itch and fatigue after burn injury.
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