Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics.

Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics. Research Abstract Details 

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Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics. Abstract Text:

Amber E Barnato,Sherri L Alexander,Walter T Linde-Zwirble,Derek C Angus,Amber E Barnato,Sherri L Alexander,Walter T Linde-Zwirble,Derek C Angus,Amber E Barnato,Sherri L Alexander,Walter T Linde-Zwirble,Derek C Angus,

RATIONALE: Higher rates of sepsis have been reported in minorities. OBJECTIVES: To explore racial differences in the incidence and associated case fatality of severe sepsis, accounting for clinical, social, health care service delivery, and geographic characteristics. METHODS: Retrospective population-based cohort study using hospital discharge and U.S. Census data for all persons (n = 71,102,655) living in 68 hospital referral regions in six states. Measurements and Main Results: Age-, sex- and race-standardized severe sepsis incidence and inpatient case fatality rates, adjusted incidence rate ratios, and adjusted intensive care unit (ICU) admission and case fatality rate differences. Of 8,938,111 nonfederal hospitalizations, 282,292 had severe sepsis. Overall, blacks had the highest age- and sex-standardized population-based incidence (6.08/1,000 vs. 4.06/1,000 for Hispanics and 3.58/1,000 for whites) and ICU case fatality (32.1 vs. 30.4% for Hispanics and 29.3% for whites, P < 0.0001). Adjusting for differences in poverty in their region of residence, blacks still had a higher population-based incidence of severe sepsis (adjusted rate ratio, 1.44 [95% CI, 1.42-1.46]) than whites, but Hispanics had a lower incidence (adjusted rate ratio, 0.91 [0.90-0.92]). Among patients with severe sepsis admitted to the ICU, adjustments for clinical characteristics and the treating hospital fully explained blacks' higher ICU case fatality. CONCLUSIONS: Higher adjusted black incidence and the lower Hispanic incidence may reflect residual confounding, or it could signal biologic differences in susceptibility. Focused interventions to improve processes and outcomes of care at the hospitals that disproportionately treat blacks could narrow disparities in overall mortality from severe sepsis.

Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics. Publishing Authors By Initials

AE Barnato,SL Alexander,WT Linde-Zwirble,DC Angus,AE Barnato,SL Alexander,WT Linde-Zwirble,DC Angus,AE Barnato,SL Alexander,WT Linde-Zwirble,DC Angus,

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Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: American journal of respiratory and critical care

VOLUME: 177

Page Numbers: 279-84

Journal Abbreviation: Am. J. Respir. Crit. Care Med.

ISSN: 1535-4970

DAY: 1

MONTH: 11

YEAR: 2007

Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics. Information

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LANGUAGE: eng

NlmUniqueID: 9421642

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Grant and Affiliation Information for Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics.

AFFILIATION: Center for Research on Health Care, 200 Meyran Ave., Suite 200, Pittsburgh, PA 15213, USA. aeb2@pitt.edu

Country: United States

AGENCY: United States NIA

GRANT: K08 AG21921

ACRONYM: AG

MEDLINETA: Am J Respir Crit Care Med

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