Racial Differences in Mortality from Severe Acute Respiratory Failure in the United States, 2008-2012.
Racial disparities in health and healthcare in the United States are well documented and are increasingly recognized in acute critical illnesses such as sepsis and acute respiratory failure.



Using a large, representative, U.S. nationwide database, we examined the hypothesis that black and Hispanic patients with severe acute respiratory failure have higher mortality rates when compared with non-Hispanic whites.



This retrospective analysis used discharge data from the Agency for Healthcare Research and Quality, Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, for the years 2008-2012. We identified hospitalizations with acute respiratory failure using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification, codes. A logistic regression model was fitted to compare in-hospital mortality rates by race.



After adjusting for sex, age, race, disease severity, type of hospital, and median household income for patient ZIP code, blacks had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.11-1.14; P < 0.001), and Hispanics also had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (OR, 1.17; 95% CI, 1.15-1.19; P < 0.001), and so did Asian and Pacific Islanders (OR, 1.15; 95% CI, 1.12-1.18; P < 0.001) and Native Americans (OR, 1.08; 95% CI, 1.00-1.15; P < 0.001) when compared with non-Hispanic whites (OR, 1.0).



Blacks, Hispanics, and other racial minorities in the United States were observed to exhibit significantly higher in-hospital sepsis-related respiratory failure associated mortality when compared with non-Hispanic whites.
1 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, and.|2 University of Arizona Health Sciences, Tucson, Arizona; and.
Christian
0000-0003-4787-2685
C
Bime
3 Division of Internal Medicine, Department of Medicine, University of Arizona, College of Medicine, Tucson, Arizona.|2 University of Arizona Health Sciences, Tucson, Arizona; and.
Chithra
C
Poongkunran
4 University Information Technology Services, University of Arizona, Tucson, Arizona.
Mark
M
Borgstrom
1 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, and.|2 University of Arizona Health Sciences, Tucson, Arizona; and.
Bhupinder
0000-0002-3871-0513
B
Natt
3 Division of Internal Medicine, Department of Medicine, University of Arizona, College of Medicine, Tucson, Arizona.|2 University of Arizona Health Sciences, Tucson, Arizona; and.
Hem
H
Desai
1 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, and.|2 University of Arizona Health Sciences, Tucson, Arizona; and.
Sairam
S
Parthasarathy
1 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, and.|2 University of Arizona Health Sciences, Tucson, Arizona; and.
Joe G N
JG
Garcia
D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D017052:Hospital Mortality / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012131:Respiratory Insufficiency / Q000208:ethnology* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology
ethnicity; health disparities; mortality; race; respiratory failure
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