Infection Rate and Acute Organ Dysfunction Risk as Explanations for Racial Differences in Severe Sepsis

Authors:
  • WLWalter T. Linde-Zwirble
    Walter T. Linde-Zwirble
  • OPOctavia M. Peck-Palmer
    Octavia M. Peck-Palmer
  • ABAmber E. Barnato
    Amber E. Barnato
  • LWLisa A. Weissfeld
    Lisa A. Weissfeld
  • DADerek C. Angus
    Derek C. Angus
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Abstract
Severe sepsis is a broad clinical syndrome defined as infection complicated by acute organ dysfunction.1 It affects more than 750 000 US residents each year, with a hospital mortality of 28%.2 Epidemiological studies consistently report a higher incidence of severe sepsis among black than white patients.3 However, it is not known whether these disparities occur because of differences in susceptibility to infection or in the risk of developing acute organ dysfunction once infection has occurred. This distinction is important for developing interventions to reduce disparities. For example, if racial differences in severe sepsis are largely due to differences in the incidence of infection, efforts to reduce disparities should focus on community-based interventions, such as vaccination. On the other hand, if disparities are largely due to differences in the incidence of organ dysfunction, improving the management of black patients hospitalized with severe infections will be necessary.

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