Disparities Seen in Pediatric Sepsis Outcomes in the U.S.
Black children have higher odds of death; Hispanic and Black children have longer hospital stays, especially Black neonates
WEDNESDAY, Dec. 23, 2020 (HealthDay News) -- For children with severe sepsis, outcomes vary by race or ethnicity and by insurance status, according to a study published online Dec. 14 in The Lancet Child & Adolescent Health.
Hannah K. Mitchell, B.M.B.S., from the Children's Hospital of Philadelphia, and colleagues conducted a retrospective cohort study using data from the 2016 Healthcare Cost and Utilization Project Kids' Inpatient Database. The association between race or ethnicity and insurance status and hospital mortality was examined among 12,297 children with severe sepsis who were admitted to 1,253 hospitals; the final cohort included 9,816 children.
The researchers found that compared with White children, Black children had higher odds of death (adjusted odds ratio, 1.19), driven by higher Black mortality in the Southern and Western United States (adjusted odds ratios, 1.30 and 1.58, respectively). There was evidence of longer hospital stays for Hispanic and Black children (adjusted hazard ratios, 0.94 and 0.88, respectively), especially Black neonates (adjusted hazard ratio, 0.53). There was no difference in survival noted for publicly and privately insured children; increased mortality was seen in association with "other" insurance status (self-pay, no charge, and other: adjusted odds ratio, 1.30).
"Future research should look for further disparities in sepsis care and outcomes, as well as explore the mechanisms that underlie their existence," the authors write. "A clearer understanding of the reasons that these disparities exist will enable health care systems to develop interventions to combat them."