For the treatment of sepsis among patients of low socioeconomic status, Black individuals had shorter lengths of stay in the hospital and lower average costs, but similar rates of mortality compared to White individuals. Researchers presented their findings at AMCP 2022.

“Race and socioeconomic status can influence the management and outcomes of sepsis,” authors wrote. “While the role of socioeconomic status in sepsis [has] been described, individual components that comprise…socioeconomic status such as education, poverty, and place of residence are often treated separately, leading to difficulties in interpretability and application of results.”

The retrospective cohort study included 3214 patients treated for sepsis at Barnes-Jewish Hospital from 2014-2017.

Authors determined patient demographics and outcomes using electronic health records, and assigned patients to low, moderate, or high socioeconomic status cohorts using the American Community Survey database and patient ZIP codes. The evaluation of socioeconomic status included median household income, median house value, median rent, education level, percentage below 150% of the poverty line, percentage working class, and percentage unemployed.

Of the final sample, there were 1834 White patients and 1380 Black patients.

Among individuals with low socioeconomic status, Black patients saw lower mean pharmacy ($5421.05 vs $7428.42) and total costs ($52,708.56 vs $69,928.73) and had shorter average lengths of stay in the acute setting (hospital: 12.4 vs 14.9 days, P = .01; ICU: 5.9 vs 7.4 days, P = .02) compared to White patients. Black patients also required less vasopressors (47.8% vs 55.7%, P = .02) and mechanical ventilation (44% vs 52.5%, P = .01). However, mortality rates were similar between Black and White patients of low socioeconomic status, at 23.6% and 27.9%, respectively.

In cohorts with moderate and high socioeconomic status, data indicated White patients used vasopressors more and had longer lengths of stay in the ICU compared to Black patients.

Additionally, researchers found no significant differences among costs and outcomes for Black patients across socioeconomic groups. Ventilator use was the only outcome that varied for White patients across groups.

“There was an association of disparities in costs and outcomes of sepsis between Black and White individuals, which was pronounced in low socioeconomic groups. The findings suggest that race plays a role in sepsis disparities and warrants further investigation focusing on socially disadvantaged populations,” researchers concluded.

Reference:
Yoon H, Teshome B, Griggs S, Micek S. Examining disparities in sepsis cost and outcomes across socioeconomic and race groups using dimension reduction analysis. Poster presented at: AMCP 2022; March 29-April 1, 2022; Chicago, IL.