Racial Disparities in Sepsis Explained by Two Factors

Higher incidence among black individuals attributed to higher infection rate, organ dysfunction risk

TUESDAY, June 22 (HealthDay News) -- Racial differences in sepsis rates are due to higher infection rates as well as a higher risk of organ dysfunction among black patients compared with white patients, according to research published in the June 23/30 issue of the Journal of the American Medical Association.

Florian B. Mayr, M.D., of the University of Pittsburgh, and colleagues analyzed 8,661,227 hospital discharges from seven states in 2005 to determine whether the higher reported severe sepsis incidence among black individuals was due to a higher infection rate or a higher risk of acute organ dysfunction.

The researchers found that black patients had a 67 percent higher risk of severe sepsis and an 80 percent higher mortality rate than white patients. The differences were explained by two factors: a significantly increased infection rate in blacks versus whites (incidence rate ratio, 1.39), as well as a significantly higher risk of developing acute organ dysfunction (age- and sex-adjusted odds ratio, 1.29). After adjustment for other factors, including poverty and hospital effect, the increased risk of organ dysfunction among black individuals persisted but was attenuated (odds ratio, 1.14).

"In conclusion, higher severe sepsis rates among black patients are explained by both higher infection-related hospitalization rates and a higher risk of acute organ dysfunction. Reducing these racial disparities will require community-based interventions, such as vaccination, improved management of chronic diseases, and hospital-based interventions targeted especially to hospitals that serve large proportions of black patients. Current guidelines for pneumococcal vaccination, one of the largest and most effective strategies to prevent severe sepsis, do not target up to 25 percent of cases among blacks," the authors write.

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