Clinical status of hospitalized keloid cases from 2013 to 2018

Zhe Zhu; Weishi Kong; Haibo Wang; Yongqiang Xiao; Ying Shi; Lanxia Gan; Yu Sun; Hongtai Tang; Zhaofan Xia

doi:10.1016/j.burns.2021.12.007

Clinical status of hospitalized keloid cases from 2013 to 2018

Burns. 2022 Dec;48(8):1874-1884. doi: 10.1016/j.burns.2021.12.007. Epub 2021 Dec 27.

Authors

Zhe Zhu¹, Weishi Kong¹, Haibo Wang², Yongqiang Xiao³, Ying Shi⁴, Lanxia Gan⁴, Yu Sun⁵, Hongtai Tang⁶, Zhaofan Xia⁷

Affiliations

¹ Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China.
² Clinical Trial Unit, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; Centre for Data Science in Health and Medicine, Peking University, Beijing, China.
³ Department of Burn and Plastic Surgery, The 970th Hospital of PLA, Yantai, Shandong, China.
⁴ China Standard Medical Information Research Center, Shenzhen, China.
⁵ Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address: littlefish0916@126.com.
⁶ Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address: drtanght@163.com.
⁷ Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address: Xiazhaofan_smmu@163.com.

PMID: 34980519
DOI: 10.1016/j.burns.2021.12.007

Abstract

Objects: Keloids are intractable scar diseases and sometimes undergo hospitalization. This study aims to represent current status of keloid management in a national sample of hospitalized scar cases.

Methods: Data of scar-diagnosed cases admitted in 1064 China's tertiary hospitals between 2013 and 2018, were obtained from the Hospital Quality Monitoring System (HQMS) database. Variables analyzed include sex, age, nationality, occupation, hospital department, accompanied symptoms at admission, surgical treatment, length of stay (LOS), and hospitalization cost. The potential risk factors of keloid diagnosis among scar cases were preliminarily identified through the Cochran-Mantel-Haenszel tests and univariate regression analyses.

Results: This study identified 177,586 scar cases including 21,777 keloid cases and 155,809 non-keloid scar cases. The prevalence of scars in the HQMS database was gradually decreased from 0.123% in 2013 to 0.075% in 2018. We found a preponderances of males (54.32%), adults (61.52%), Han nationality (93.38%), and students (17.35%) in scar cases, among whom keloid cases accounted for growing proportions increasing from 9.2% in 2013 to 15.1% in 2018. Comparing non-keloid scar cases, keloid cases consisted of more women (59.1% VS 43.8%), office staffs (13.08% VS 6.75%) and retirees (5.16% VS 2.65%), and less Zhuang (0.79% VS 1.40%) and Hui nationalities (0.76% VS 1.00%), and showed lower incidence of accompanied symptoms (4.51% VS 47.96%) and higher rate of receiving operations (57.96% VS 50.28%, P < 0.001). Both the LOS and cost per hospitalization were lower in keloid cases. Furthermore, the adult and older women, Han and Uyghur nationalities, office staffs and retirees, and admitted in otolaryngology and dermatology departments, were potential predictors of keloid diagnosis among hospitalized scar cases.

Conclusion: When viewed at the national level, keloid occupies an important part in scar management in Chinese tertiary hospitals. Demographic and clinical differences between keloids and other scars facilitate understanding and promoting of individualized anti-scar therapeutic strategies.

Keywords: Electronic health records; Hospitalization; Keloids; Medical information; Pathological scars.

MeSH terms

Adult
Aged
Asian People
Burns* / complications
Cicatrix, Hypertrophic* / pathology
Female
Hospitalization
Humans
Keloid* / epidemiology
Keloid* / pathology
Male
Risk Factors