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Racial Inequities in Sepsis Mortality Among Children in the United States.

Publication ,  Journal Article
Moorthy, GS; Young, RR; Smith, MJ; White, MJ; Hong, H; Kelly, MS
Published in: Pediatr Infect Dis J
May 1, 2023

BACKGROUND: Racial inequities influence health outcomes in the United States, but their impact on sepsis outcomes among children is understudied. We aimed to evaluate for racial inequities in sepsis mortality using a nationally representative sample of pediatric hospitalizations. METHODS: This population-based, retrospective cohort study used the 2006, 2009, 2012 and 2016 Kids' Inpatient Database. Eligible children 1 month to 17 years old were identified using sepsis-related International Classification of Diseases, Ninth Revision or International Classification of Diseases, Tenth Revision codes. We used modified Poisson regression to evaluate the association between patient race and in-hospital mortality, clustering by hospital and adjusting for age, sex and year. We used Wald tests to assess for modification of associations between race and mortality by sociodemographic factors, geographic region and insurance status. RESULTS: Among 38,234 children with sepsis, 2555 (6.7%) died in-hospital. Compared with White children, mortality was higher among Hispanic (adjusted relative risk: 1.09; 95% confidence interval: 1.05-1.14), Asian/Pacific Islander (1.17, 1.08-1.27) and children from other racial minority groups (1.27, 1.19-1.35). Black children had similar mortality to White children overall (1.02, 0.96-1.07), but higher mortality in the South (7.3% vs. 6.4%; P < 0.0001). Hispanic children had higher mortality than White children in the Midwest (6.9% vs. 5.4%; P < 0.0001), while Asian/Pacific Islander children had higher mortality than all other racial categories in the Midwest (12.6%) and South (12.0%). Mortality was higher among uninsured children than among privately insured children (1.24, 1.17-1.31). CONCLUSIONS: Risk of in-hospital mortality among children with sepsis in the United States differs by patient race, geographic region and insurance status.

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Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

May 1, 2023

Volume

42

Issue

5

Start / End Page

361 / 367

Location

United States

Related Subject Headings

  • White
  • United States
  • Sepsis
  • Retrospective Studies
  • Racial Groups
  • Pediatrics
  • Humans
  • Hospital Mortality
  • Hispanic or Latino
  • Health Status Disparities
 

Citation

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Moorthy, G. S., Young, R. R., Smith, M. J., White, M. J., Hong, H., & Kelly, M. S. (2023). Racial Inequities in Sepsis Mortality Among Children in the United States. Pediatr Infect Dis J, 42(5), 361–367. https://doi.org/10.1097/INF.0000000000003842
Moorthy, Ganga S., Rebecca R. Young, Michael J. Smith, Michelle J. White, Hwanhee Hong, and Matthew S. Kelly. “Racial Inequities in Sepsis Mortality Among Children in the United States.Pediatr Infect Dis J 42, no. 5 (May 1, 2023): 361–67. https://doi.org/10.1097/INF.0000000000003842.
Moorthy GS, Young RR, Smith MJ, White MJ, Hong H, Kelly MS. Racial Inequities in Sepsis Mortality Among Children in the United States. Pediatr Infect Dis J. 2023 May 1;42(5):361–7.
Moorthy, Ganga S., et al. “Racial Inequities in Sepsis Mortality Among Children in the United States.Pediatr Infect Dis J, vol. 42, no. 5, May 2023, pp. 361–67. Pubmed, doi:10.1097/INF.0000000000003842.
Moorthy GS, Young RR, Smith MJ, White MJ, Hong H, Kelly MS. Racial Inequities in Sepsis Mortality Among Children in the United States. Pediatr Infect Dis J. 2023 May 1;42(5):361–367.

Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

May 1, 2023

Volume

42

Issue

5

Start / End Page

361 / 367

Location

United States

Related Subject Headings

  • White
  • United States
  • Sepsis
  • Retrospective Studies
  • Racial Groups
  • Pediatrics
  • Humans
  • Hospital Mortality
  • Hispanic or Latino
  • Health Status Disparities