An Exploration of Drivers of Sepsis Outcomes in Racial and Ethnic Minority Populations
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Publication Date
4-29-2026
Keywords
oregon, psvmc, psvmc gme, psvmc oaa
Disciplines
Medical Education
Abstract
RATIONALE: Race and ethnicity affect sepsis outcomes in unclear ways. Existing data is conflicting, with some studies suggesting minority patients do worse, while others did not show a difference in outcomes between these groups. We sought to investigate whether inequalities exist in sepsis outcomes for different racial and ethnic groups in our large hospital system and to characterize how they may manifest. METHODS: We performed a retrospective cohort study of adults diagnosed with sepsis and discharged from any of Providence’s 52 hospitals between January 1 and December 31, 2023. We grouped patients into ten different race/ethnicity groups including White, Black, Hispanic/Latinx, Black, Asian, Middle Eastern/North African, American Indian/Alaska Native, and other/ unknown/chose not to disclose. Patient age, gender, insurance payer, and medical comorbidity groups were determined. In-hospital mortality, hospital length of stay (LOS), 30-day readmission rate, lactic acid level, sepsis order set usage, and initial, final, and maximum sequential organ failure assessment (SOFA) scores were abstracted from the electronic medical record. RESULTS: We identified 44,443 sepsis patients, of whom the mean age was 65.3 years and 52.7% were male. 65.2% were White, 17.0% were Hispanic/Latinx, 5.2% were Asian, 4.1% were Black, and 1.3% were Native American. White (67.9 years) and Asian (68.1 years) patients were of similar average age, while Black (59.4 years), Hispanic (57.2 years), and Native American (54.4 years) patients were younger. Hispanic/ Latinx patients had a 2.46% lower mortality rate (p < 0.0001) than White patients. Black patients had a LOS of 0.63 days longer (p < 0.0001) than White patients on average, while Hispanic patients had a 0.51-day shorter LOS (p< 0.0001). Readmission rates were similar across groups. Black and Asian patients had higher initial, maximum, and final SOFA scores than Whites (p < 0.0001). Asian patients also had a higher lactic acid level by 0.13 mmol/L (p = 0.0001) than White patients. CONCLUSIONS: We noted a significant difference in the average age of each race/ethnicity group, meaning that despite similar mortality rates, Black and Native American patients on average present and die younger of sepsis than White patients. Similarly, age may account for much of the mortality benefit associated with the Hispanic/Latinx group. Further study investigating years of potential life lost may help better elucidate these disparities. Disparities in the severity of presenting illness of Black and Asian patients may be due to delayed recognition in the prehospital setting.
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Internal Medicine
