The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients
Abstract Background Previous studies have been inconclusive about racial disparities in sepsis. This study evaluated the impact of ethnic background on management and outcome in sepsis and septic shock. Methods This analysis included 17,146 patients suffering from sepsis and septic shock from the mu...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08170-7 |
| _version_ | 1797853977260326912 |
|---|---|
| author | Andreas Koköfer Behrooz Mamandipoor Maria Flamm Richard Rezar Sarah Wernly Christian Datz Christian Jung Venet Osmani Bernhard Wernly Raphael Romano Bruno |
| author_facet | Andreas Koköfer Behrooz Mamandipoor Maria Flamm Richard Rezar Sarah Wernly Christian Datz Christian Jung Venet Osmani Bernhard Wernly Raphael Romano Bruno |
| author_sort | Andreas Koköfer |
| collection | DOAJ |
| description | Abstract Background Previous studies have been inconclusive about racial disparities in sepsis. This study evaluated the impact of ethnic background on management and outcome in sepsis and septic shock. Methods This analysis included 17,146 patients suffering from sepsis and septic shock from the multicenter eICU Collaborative Research Database. Generalized estimated equation (GEE) population-averaged models were used to fit three sequential regression models for the binary primary outcome of hospital mortality. Results Non-Hispanic whites were the predominant group (n = 14,124), followed by African Americans (n = 1,852), Hispanics (n = 717), Asian Americans (n = 280), Native Americans (n = 146) and others (n = 830). Overall, the intensive care treatment and hospital mortality were similar between all ethnic groups. This finding was concordant in patients with septic shock and persisted after adjusting for patient-level variables (age, sex, mechanical ventilation, vasopressor use and comorbidities) and hospital variables (teaching hospital status, number of beds in the hospital). Conclusion We could not detect ethnic disparities in the management and outcomes of critically ill septic patients and patients suffering from septic shock. Disparate outcomes among critically ill septic patients of different ethnicities are a public health, rather than a critical care challenge. |
| first_indexed | 2024-04-09T19:59:27Z |
| format | Article |
| id | doaj.art-4604373eb649413cbe38ffc47b96b8d5 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-09T19:59:27Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-4604373eb649413cbe38ffc47b96b8d52023-04-03T05:18:03ZengBMCBMC Infectious Diseases1471-23342023-03-012311910.1186/s12879-023-08170-7The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patientsAndreas Koköfer0Behrooz Mamandipoor1Maria Flamm2Richard Rezar3Sarah Wernly4Christian Datz5Christian Jung6Venet Osmani7Bernhard Wernly8Raphael Romano Bruno9Department of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University of SalzburgFondazione Bruno Kessler Research InstituteInstitute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University of SalzburgDepartment of Cardiology, Paracelsus Medical University of SalzburgDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital, Paracelsus Medical University of SalzburgDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital, Paracelsus Medical University of SalzburgDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfFondazione Bruno Kessler Research InstituteInstitute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University of SalzburgDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfAbstract Background Previous studies have been inconclusive about racial disparities in sepsis. This study evaluated the impact of ethnic background on management and outcome in sepsis and septic shock. Methods This analysis included 17,146 patients suffering from sepsis and septic shock from the multicenter eICU Collaborative Research Database. Generalized estimated equation (GEE) population-averaged models were used to fit three sequential regression models for the binary primary outcome of hospital mortality. Results Non-Hispanic whites were the predominant group (n = 14,124), followed by African Americans (n = 1,852), Hispanics (n = 717), Asian Americans (n = 280), Native Americans (n = 146) and others (n = 830). Overall, the intensive care treatment and hospital mortality were similar between all ethnic groups. This finding was concordant in patients with septic shock and persisted after adjusting for patient-level variables (age, sex, mechanical ventilation, vasopressor use and comorbidities) and hospital variables (teaching hospital status, number of beds in the hospital). Conclusion We could not detect ethnic disparities in the management and outcomes of critically ill septic patients and patients suffering from septic shock. Disparate outcomes among critically ill septic patients of different ethnicities are a public health, rather than a critical care challenge.https://doi.org/10.1186/s12879-023-08170-7SepsisIntensive careCritically illElderlyVery elderlyOld |
| spellingShingle | Andreas Koköfer Behrooz Mamandipoor Maria Flamm Richard Rezar Sarah Wernly Christian Datz Christian Jung Venet Osmani Bernhard Wernly Raphael Romano Bruno The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients BMC Infectious Diseases Sepsis Intensive care Critically ill Elderly Very elderly Old |
| title | The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients |
| title_full | The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients |
| title_fullStr | The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients |
| title_full_unstemmed | The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients |
| title_short | The impact of ethnic background on ICU care and outcome in sepsis and septic shock – A retrospective multicenter analysis on 17,949 patients |
| title_sort | impact of ethnic background on icu care and outcome in sepsis and septic shock a retrospective multicenter analysis on 17 949 patients |
| topic | Sepsis Intensive care Critically ill Elderly Very elderly Old |
| url | https://doi.org/10.1186/s12879-023-08170-7 |
| work_keys_str_mv | AT andreaskokofer theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT behroozmamandipoor theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT mariaflamm theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT richardrezar theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT sarahwernly theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT christiandatz theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT christianjung theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT venetosmani theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT bernhardwernly theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT raphaelromanobruno theimpactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT andreaskokofer impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT behroozmamandipoor impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT mariaflamm impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT richardrezar impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT sarahwernly impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT christiandatz impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT christianjung impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT venetosmani impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT bernhardwernly impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients AT raphaelromanobruno impactofethnicbackgroundonicucareandoutcomeinsepsisandsepticshockaretrospectivemulticenteranalysison17949patients |