Race and sex based disparities in sepsis.

Area of Science:

• Critical Care Medicine
• Health Services Research
• Epidemiology

Background:

• Previous studies on sepsis disparities used administrative data, limiting accurate diagnosis and race/sex analysis.
• Limited research has simultaneously examined sex and race in sepsis outcomes.
• Administrative databases may not fully capture sepsis diagnosis or include diverse racial groups.

Purpose of the Study:

• To investigate sex- and race-based differences in mortality among sepsis patients.
• To determine if race and sex influence the receipt of mechanical ventilation or renal replacement therapy.
• To analyze disparities in time to antibiotic administration for sepsis.

Main Methods:

• Retrospective analysis of clinical data from 34,999 sepsis patients.
• Sepsis diagnosis defined using Sepsis-3 criteria.
• Logistic and linear regression models used for adjusted analyses.

Main Results:

• Asian females had the lowest adjusted 90-day mortality compared to White males (OR=0.656).
• African-American males also showed lower adjusted mortality (OR=0.790).
• Patients with Other/unknown race had significantly higher mortality (OR=1.776 for males, OR=1.658 for females).
• No significant associations were found between race-sex groups and the receipt of mechanical ventilation or renal replacement therapy.

Conclusions:

• Asian females exhibit the lowest adjusted 90-day mortality following sepsis.
• Understanding the underlying reasons for these observed race and sex disparities is crucial.
• Addressing these disparities can lead to improved sepsis care and outcomes across diverse patient populations.