Race Does Not Impact Sepsis Outcomes When Considering Socioeconomic Factors in Multilevel Modeling.
Journal
Critical care medicine
ISSN: 1530-0293
Titre abrégé: Crit Care Med
Pays: United States
ID NLM: 0355501
Informations de publication
Date de publication:
01 03 2022
01 03 2022
Historique:
pubmed:
15
7
2021
medline:
11
3
2022
entrez:
14
7
2021
Statut:
ppublish
Résumé
To determine whether race is a major determinant of sepsis outcomes when controlling for socioeconomic factors. Retrospective cohort study. Barnes-Jewish Hospital a 1,350 bed academic medical center. Eleven-thousand four-hundred thirty-two patients hospitalized between January 2010 and April 2017 with sepsis and septic shock. Multilevel random effects modeling was employed whereby patients were nested within ZIP codes. Individual patient characteristics and socioeconomic variables aggregated at the ZIP code level (education, employment status, income, poverty level, access to healthcare) were included in the model. In hospital mortality, length of stay, need for vasopressors, and mechanical ventilation were the main endpoints. Black patients had more comorbidities than White patients except for cirrhosis and malignancy. In unadjusted comparisons, White individuals were more likely to require mechanical ventilation and had higher mortality rates and longer hospital stays for both low- and high-income groups. When nesting within ZIP codes and accounting for socioeconomic variables, race did not have a significant effect on mortality. Non-White races had lower odds ratio for mechanical ventilation. Our study demonstrates that race is not an independent risk factor for sepsis mortality, as well as sepsis-related length of stay. We should expand our inquiry into determinants of sepsis outcomes by including socioeconomic variables.
Identifiants
pubmed: 34259658
doi: 10.1097/CCM.0000000000005217
pii: 00003246-202203000-00006
pmc: PMC9366968
mid: NIHMS1824492
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
410-417Subventions
Organisme : NIGMS NIH HHS
ID : K08 GM140310
Pays : United States
Informations de copyright
Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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