Occurrence and outcomes of sepsis: influence of race.
OBJECTIVE
To evaluate premorbid conditions and sociodemographic characteristics associated with differences in hospitalization and mortality rates of sepsis in blacks and whites.


METHODS
Secondary data analysis of the publicly available New Jersey State Inpatient Database for 2002.


METHODS
Acute care hospitals in New Jersey.


METHODS
All black and white adult patients with sepsis hospitalized in 2002.


METHODS
None.


RESULTS
A total of 5,466 black and 19,373 white adult patients with sepsis were identified with the International Classification of Diseases, Ninth Revision, Clinical Modification codes for septicemia. Blacks were significantly younger than whites (61.6 +/- 0.25 and 72.8 +/- 0.11 yrs, respectively, p < .0001). Blacks had greater hospitalization rates than whites, with the greatest disparity between the ages of 35 and 44 yrs (relative risk, 4.35; 95% confidence interval, 3.93-4.82). Compared with whites, blacks had higher age-adjusted rates for hospitalization and mortality but similar case fatality rates. They were more likely than whites to be admitted to the hospital through the emergency room (odds ratio, 1.4; 95% confidence interval, 1.27-1.50) and to the intensive care unit (odds ratio, 1.14; 95% confidence interval, 1.07-1.21), and they were 3.96 times (95% confidence interval, 3.44-4.56) more likely to be uninsured. Black patients with sepsis had a greater likelihood of human immunodeficiency virus infection, diabetes, obesity, burns, and chronic renal failure than white patients and had a smaller likelihood of cancer, trauma, and urinary tract infection.


CONCLUSIONS
In this study, age-adjusted case fatality rates for hospitalized white and black patients with sepsis were similar. These data are not suggestive of systematic disparities in the quality of treatment of sepsis between blacks and whites. However, blacks had higher rates of hospitalization and population-based mortality for sepsis. We speculate that disparities in disease prevention and care of preexisting conditions before sepsis onset may explain these differences.
Dombrovskiy
Viktor Y
VY
Division of Pulmonary and Critical Care Medicine, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Martin
Andrew A
AA
Sunderram
Jagadeeshan
J
Paz
Harold L
HL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D009515:New Jersey; D012307:Risk Factors; D012737:Sex Factors; D012772:Shock, Septic / Q000208:ethnology* / Q000401:mortality; D012959:Socioeconomic Factors; D016019:Survival Analysis; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American