The Association of Race and Survival from Sepsis after Injury

Plurad, David; Lustenberger, Thomas; Kilday, Patrick; Zhu, J.; Green, Donald J.; Inaba, Kenji; Talving, Peep; Belzberg, Howard; Δημητριάδης, Δημήτριος

doi:10.1177/000313481007600109

Cited by 25 publications

(12 citation statements)

References 15 publications

(37 reference statements)

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“…There has been conflicting data regarding the role of race and mortality outcomes in severe sepsis. Prior data suggests that Asian 27 and African-American 28 race may be associated with worse mortality outcomes in severe sepsis, in general. Our investigation provides further insights regarding the impact of race as it pertains to the occurrence of cardiovascular events in severe sepsis.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis

Patel

Bajaj

Doshi

et al. 2019

The American Journal of Cardiology

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The burden of cardiovascular events among patients hospitalized with severe sepsis and the association of these events with in-hospital mortality is not well known. We examined the incidence of cardiovascular events and their association with in-hospital mortality among patients with severe sepsis. Patients with severe sepsis from the New York State Inpatient Database from 2012 through 2014 were identified using a validated ICD-9-CM code 995.92. The primary outcome was the incidence of cardiovascular events during the hospitalizations, defined as a composite of ischemic, acute heart failure (HF), or arrhythmic events and the secondary outcome was in-hospital mortality. Multivariable logistic regression models were used to compare the risk of in-hospital mortality among severe sepsis patients with and without cardiovascular events. A total of 117,418 patients (mean age, 70.8 years; 50.4% males, 59.5% whites) with severe sepsis occurred during the study period 2012-2014. New-onset (incident) cardiovascular event occurred in 31.7%, ischemic events in 9.3%, acute HF events in 6.9%, and arrhythmic events in 23.4% of

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis

Patel

Bajaj

Doshi

et al. 2019

The American Journal of Cardiology

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“…Nevertheless, sepsis is clearly associated with high mortality. Studies have found that the mortality from trauma-related sepsis is significantly higher than mortality from trauma alone [68, 69]. PCT has been shown to reflect the prognosis of sepsis in septic patients.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of serum procalcitonin measurements in critically injured patients: a systematic review

et al. 2019

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BackgroundMajor trauma is associated with high incidence of septic complications and multiple organ dysfunction (MOD), which markedly influence the outcome of injured patients. Early identification of patients at risk of developing posttraumatic complications is crucial to provide early treatment and improve outcomes. We sought to evaluate the prognostic value of serum procalcitonin (PCT) levels after trauma as related to severity of injury, sepsis, organ dysfunction, and mortality.MethodsWe searched PubMed, MEDLINE, EMBASE, the Cochrane Database, and references of included articles. Two investigators independently identified eligible studies and extracted data. We included original studies that assessed the prognostic value of serum PCT levels in predicting severity of injury, sepsis, organ dysfunction, and mortality among critically injured adult patients.ResultsAmong 2015 citations, 19 studies (17 prospective; 2 retrospective) met inclusion criteria. Methodological quality of included studies was moderate. All studies showed a strong correlation between initial PCT levels and Injury Severity Score (ISS). Twelve out of 16 studies demonstrated significant elevation of initial PCT levels in patients who later developed sepsis after trauma. PCT level appeared a strong predictor of MOD in seven out of nine studies. While two studies did not show association between PCT levels and mortality, four studies demonstrated significant elevation of PCT levels in non-survivors versus survivors. One study reported that the PCT level of ≥ 5 ng/mL was associated with significantly increased mortality (OR 3.65; 95% CI 1.03–12.9; p = 0.04).ConclusionPCT appears promising as a surrogate biomarker for trauma. Initial peak PCT level may be used as an early predictor of sepsis, MOD, and mortality in trauma population.

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“…Six cohort studies investigated the impact of race on the development of sepsis, and four identified a higher risk of sepsis development in Black patients compared with White patients (14-17) (Table 2). In contrast, two studies found that White patients had a higher incidence of sepsis compared with Black patients (18,19). Fifty percent of the studies also investigated at least one non-White and non-Black population.…”

Section: Racementioning

confidence: 99%

Social Determinants of Health Associated With the Development of Sepsis in Adults: A Scoping Review

Sheikh

Douglas

Catenacci

et al. 2022

Critical Care Explorations

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OBJECTIVE: Evaluating risk for sepsis is complicated due to limited understanding of how social determinants of health (SDoH) influence the occurence of the disease. This scoping review aims to identify gaps and summarize the existing literature on SDoH and the development of sepsis in adults. DATA SOURCES: A literature search using key terms related to sepsis and SDoH was conducted using Medline and PubMed. STUDY SELECTION: Studies were screened by title and abstract and then full text in duplicate. Articles were eligible for inclusion if they: 1) evaluated at least one SDoH on the development of sepsis, 2) participants were 18 years or older, and 3) the studies were written in English between January 1970 and January 2022. Systematic reviews, meta-analyses, editorials, letters, commentaries, and studies with nonhuman participants were excluded. DATA EXTRACTION: Data were extracted in duplicate using a standardized data extraction form. Studies were grouped into five categories according to the SDoH they evaluated (race, socioeconomic status [SES], old age and frailty, health behaviors, and social support). The study characteristics, key outcomes related to incidence of sepsis, mortality, and summary statements were included in tables. DATA SYNTHESIS: The search identified 637 abstracts, 20 of which were included after full-text screening. Studies evaluating SES, old age, frailty, and gender demonstrated an association between sepsis incidence and the SDoH. Studies that examined race demonstrated conflicting conclusions as to whether Black or White patients were at increased risk of sepsis. Overall, a major limitation of this analysis was the methodological heterogeneity between studies. CONCLUSIONS: There is evidence to suggest that SDoH impacts sepsis incidence, particularly SES, gender, old age, and frailty. Future prospective cohort studies that use standardized methods to collect SDoH data, particularly race-based data, are needed to inform public health efforts to reduce the incidence of sepsis and help clinicians identify the populations most at risk.

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The Association of Race and Survival from Sepsis after Injury

Cited by 25 publications

References 15 publications

Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis

Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis

The prognostic value of serum procalcitonin measurements in critically injured patients: a systematic review

Social Determinants of Health Associated With the Development of Sepsis in Adults: A Scoping Review

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