Racial Differences in Sepsis Mortality at US Academic Medical Center-Affiliated Hospitals

Objectives: To determine the racial disparities in severe sepsis hospitalizations and outcomes in U.S. academic medical center-affiliated hospitals. Design: Retrospective analysis of sepsis hospitalizations. Settings: U.S. academic medical center-affiliated hospitals participating in Vizient Consortium from 2012 to 2014. Patients: Sepsis hospitalizations using International Classification of Diseases, Ninth revision, discharge diagnoses codes defined by the Angus method. Interventions: None. Measurements and Main Results: We compared rates of sepsis hospitalization, ICU admission, organ dysfunction, and hospital mortality between blacks and whites. We repeated the analyses stratified by community-acquired, healthcare-associated, and hospital-acquired sepsis subtypes. Of 10,244,780 hospitalizations in our cohort, 1,114,386 (10.9%) had sepsis. Sepsis subtypes included community-acquired sepsis (61.8%), healthcare-associated sepsis (23.8%), and hospital-acquired sepsis (14.4%). Although the proportion of discharges with sepsis was lower for blacks than whites (106.72 vs 109.43 per 1,000 hospitalizations; p < 0.001), the proportion of black sepsis hospitalizations was higher for individuals greater than 30 years old. Blacks exhibited lower adjusted sepsis hospital mortality than whites (odds ratio, 0.85; 95% CI, 0.84-0.86). The adjusted odds of hospital mortality following community-acquired, healthcare-associated, and hospital-acquired sepsis were lower for blacks than whites. Conclusions: In this current series of hospital discharges at U.S. academic medical center-affiliated hospitals, blacks exhibited lower adjusted rates of sepsis hospitalizations and mortality than whites.