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Association Between Race and Case Fatality Rate in Hospitalizations for Sepsis

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Background

Differentiating whether disparities in outcomes for sepsis among racial groups are due to differences in hospital care versus pre-hospitalization factors is an important step in developing effective strategies to reduce these disparities. As such, we examined the association between race and case fatality rates among hospitalizations for sepsis.

Methods

This was a case-control study of hospitalizations for sepsis in all acute-care, non-federal California hospitals during 2011. The association between hospital mortality and race was examined using hierarchical logistic regression analysis.

Results

Among 131,831 hospitalizations for sepsis, the unadjusted case fatality rates were 15.1 % in whites, 14.0 % in blacks, 13.8 % in Hispanics, and 16.2 % in Asians (P < 0.001). Compared to whites, the odds of hospital mortality was 0.84 (95 % CI 0.79–0.89) for blacks, 0.88 (95 % CI 0.84–0.92) for Hispanics, and 0.93 (95 % CI 0.87–0.98) for Asians after controlling for patient, healthcare systems, and hospital-level factors. There was no difference in the variability of sepsis mortality across hospitals between racial groups. The range of case fatality rates for sepsis among hospitals was 8.3–22.9 % for whites, 9.1–20.5 % for blacks, 7.0–19.1 % for Hispanics, and 10.0–23.0 % for Asians.

Conclusion

Case fatality rates for sepsis hospitalizations are lower in minority racial groups in California. Future studies and interventions that seek to reduce racial disparities in sepsis need to focus on pre-hospitalization factors that contribute to population-level racial differences in sepsis outcomes.

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Acknowledgments

Contributions

Drs. Sandoval and Chang are the guarantors of the contents in the manuscript including the data and analysis.

Dr. Sandoval contributed to analyzing and interpreting the data and drafted the submitted article.

Dr. Chang contributed to acquiring, analyzing, and interpreting the data; reviewed and revised the article critically for important intellectual content.

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Authors and Affiliations

  1. Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomed Research Institute at Harbor-University of California Los Angeles Medical Center, Box 405, 1000 W. Carson Street, Torrance, CA, 90509, USA

    Eric Sandoval & Dong W. Chang

  2. Department of Medicine, Harbor-UCLA Medical Center, Box 405, 1000 W. Carson Street, Torrance, CA, 90509, USA

    Dong W. Chang

Authors
  1. Eric Sandoval
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  2. Dong W. Chang
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Correspondence to Dong W. Chang.

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Conflict of Interest

Dr. Eric Sandoval has no conflicts of interest to report. Dr. Dong Chang has no conflicts of interest to report.

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Sandoval, E., Chang, D.W. Association Between Race and Case Fatality Rate in Hospitalizations for Sepsis. J. Racial and Ethnic Health Disparities 3, 625–634 (2016). https://doi.org/10.1007/s40615-015-0181-0

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  • DOI: https://doi.org/10.1007/s40615-015-0181-0

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