The DOI matches its Crossref record; 30 of the 31 references it cites were found in a registry or an index.
Racial Variation in the Incidence, Care, and Outcomes of Severe Sepsis
Open accessAbstract
Rationale: Higher rates of sepsis have been reported in minorities. Objectives: To explore racial differences in the incidence and associated case fatality of severe sepsis, accounting for clinical, social, health care service delivery, and geographic characteristics. Methods: Retrospective population-based cohort study using hospital discharge and U.S. Census data for all persons (n = 71,102,655) living in 68 hospital referral regions in six states. Measurements and Main Results: Age-, sex- and race-standardized severe sepsis incidence and inpatient case fatality rates, adjusted incidence rate ratios, and adjusted intensive care unit (ICU) admission and case fatality rate differences. Of 8,938,111 nonfederal hospitalizations, 282,292 had severe sepsis. Overall, blacks had the highest age- and sex-standardized population-based incidence (6.08/1,000 vs. 4.06/1,000 for Hispanics and 3.58/1,000 for whites) and ICU case fatality (32.1 vs. 30.4% for Hispanics and 29.3% for whites, P < 0.0001). Adjusting for differences in poverty in their region of residence, blacks still had a higher population-based incidence of severe sepsis (adjusted rate ratio, 1.44 [95% CI, 1.42–1.46]) than whites, but Hispanics had a lower incidence (adjusted rate ratio, 0.91 [0.90–0.92]). Among patients with severe sepsis admitted to the ICU, adjustments for clinical characteristics and the treating hospital fully explained blacks' higher ICU case fatality. Conclusions: Higher adjusted black incidence and the lower Hispanic incidence may reflect residual confounding, or it could signal biologic differences in susceptibility. Focused interventions to improve processes and outcomes of care at the hospitals that disproportionately treat blacks could narrow disparities in overall mortality from severe sepsis.
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“In the United States, non‐White people are overrepresented in the numbers of individuals manifesting sepsis comorbidities every year”
From On race, human variation, and who gets and dies of sepsis (2022) · cites this paper as Barnato et al., 2008
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Black and Hispanic sepsis patients in the United States have been found to be under‐treated and even under‐transferred to specialized sepsis care, even after adjustment for income and sepsis severity (Barnato et al., 2008; Tyler et al., 2018).”
From On race, human variation, and who gets and dies of sepsis (2022) · cites this paper as Barnato et al., 2008
Experimental — accuracy not yet measuredIn the citing paper
“Black, Indigenous, and People of Color bear a disproportionate burden of US annual sepsis cases.”
From On race, human variation, and who gets and dies of sepsis (2022) · cites this paper as Barnato et al., 2008
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“Race and/or ethnicity, as reported by patients and recorded in each hospital’s electronic health record database, was also included given its known association with sepsis treatment patterns and outcomes”
From Trends in empiric broad-Spectrum antibiotic use for suspected community-onset Sepsis in US hospitals (2024) · cites this paper as [28]
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Cited by
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Seymour, C. W., Liu, V. X., Iwashyna, T. J., Brunkhorst, F. M., Rea, T. D., Scherag, A., Rubenfeld, G., Kahn, J. M., Shankar-Hari, M., Singer, M., et al. (2016) · JAMA · doi:10.1001/jama.2016.0288 · Cited by 3,939
Self-citationFleischmann, C., Scherag, A., Adhikari, N. K. J., Hartog, C. S., Tsaganos, T., Schlattmann, P., Angus, D. C., & Reinhart, K. (2016) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201504-0781oc · Cited by 3,548
Self-citationSepsis: pathophysiology and clinical management
Gotts, J. E., & Matthay, M. A. (2016) · BMJ · doi:10.1136/bmj.i1585 · Cited by 1,308
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Self-citationThe Effect of Multidisciplinary Care Teams on Intensive Care Unit Mortality
Kim, M. M., Barnato, A. E., Angus, D. C., Fleisher, L., & Kahn, J. M. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.521 · Cited by 531
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Metadata
- Authors
- Barnato, A. E., Alexander, S. L., Linde-Zwirble, W. T., & Angus, D. C.
- Affiliations
- University of Pittsburgh (US)
- Genentech (US)
- ZD Associates, LLC, Perkasie, Pennsylvania
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-02-01
- Volume
- 177
- Issue
- 3
- Pages
- 279-284
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- PMC
- PMC2720103
- OpenAlex
- W2000321839
- Cited by
- 284
- References
- 31
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 16 · 2023: 23 · 2022: 22 · 2021: 14 · 2020: 13 · 2019: 16 · 2018: 14 · 2017: 13 · 2016: 24 · 2015: 12 · 2014: 6 · 2013: 8 · 2012: 18
- FWCI
- 9.21
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (K08 AG 21921, K08AG021921)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
- Keywords
- severe sepsis, racial disparities, Black patients, Hispanic patients, case fatality, sepsis incidence, intensive care unit admission, poverty, health care disparities, residual confounding, hospital quality of care
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Black or African American, Child, Child, Preschool, Critical Care, Female, Hispanic or Latino, Hospital Bed Capacity, Hospitals, Teaching, Hospitals, Urban, Humans, Infant, Infant, Newborn, Intensive Care Units, Male, Middle Aged, Practice Patterns, Physicians', Retrospective Studies, United States, Cohort Studies, Incidence, Sepsis, White People, Health Status Disparities, Healthcare Disparities
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