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4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort

OBJECTIVES/GOALS: Septic shock is a lethal condition. Research suggests that overall sepsis mortality varies by race, but less is known about demographic differences in septic shock mortality. Our objectives were to describe the septic shock population using a large, state-wide data repository and i...

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Autores principales: Black, Lauren Page, Hopson, Charlotte, DeVos, Elizabeth, Fernandez, Rosemarie, Guirgis, Faheem, Garvan, Cynthia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8822974/
http://dx.doi.org/10.1017/cts.2020.145
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author Black, Lauren Page
Hopson, Charlotte
DeVos, Elizabeth
Fernandez, Rosemarie
Guirgis, Faheem
Garvan, Cynthia
author_facet Black, Lauren Page
Hopson, Charlotte
DeVos, Elizabeth
Fernandez, Rosemarie
Guirgis, Faheem
Garvan, Cynthia
author_sort Black, Lauren Page
collection PubMed
description OBJECTIVES/GOALS: Septic shock is a lethal condition. Research suggests that overall sepsis mortality varies by race, but less is known about demographic differences in septic shock mortality. Our objectives were to describe the septic shock population using a large, state-wide data repository and identify demographic predictors of septic shock mortality. METHODS/STUDY POPULATION: This was a retrospective review of patients with septic shock in the One Florida Data Trust from 2012-2018. Patients were classified as having septic shock if they received vasopressors and had either 1) an ICD-9 or 10 code for septic shock or 2) an ICD-9 or 10 code for infection and an ICD-9 or 10 code for organ dysfunction. Demographic data and place of residence prior to admission was collected. The primary outcome was 90 day mortality. T-test and chi-square tests were used to test association of individual predictors and mortality. Multiple logistic regression was used to identify predictors of mortality after adjustment for other variables. Level of significance was set at 0.05. SAS v9.4 (Cary, NC) was used for analyses. RESULTS/ANTICIPATED RESULTS: There were 11,790 patients with septic shock. The mean(SD) age was 61(16) years. With regard to race/ethnicity 66% identified as white, 27% as black, 3.7% as Hispanic, and 3.5% as other races (non-white, non-black, non-Hispanic). Most came from home (57%). Overall, 39% died. Mortality varied by race (p<0.01): white 39%, black 39%, Hispanic 31%, other races 51%. In the logistic regression model, age, race, and residence were significant predictors of mortality, after adjustment for other variables. Each additional year of age had a 2.7% increased odds of mortality (OR 1.03; 95% CI 1.02-1.03; p<0.01). Compared to white patients, odds of death were 1.6 times higher for other races (95% CI 1.3-2.0; p <0.01) and non-significantly higher for black patients (OR 1.1; 95% CI 1.0-1.2; p = 0.05). Compared to those from home, odds of death were highest for those from a skilled nursing facility (OR 1.5; p<0.01). DISCUSSION/SIGNIFICANCE OF IMPACT: Patients who identified as other races had increased mortality from septic shock compared to white patients after adjusting for other variables. Septic shock mortality also increased with age and varied by residence. Further analyses are needed to examine racial disparities and control for comorbidities, severity of illness, and aspects of resuscitation. CONFLICT OF INTEREST DESCRIPTION: The authors report no conflicts of interest, except for Dr. Fernandez, who reports personal payment from Physio-Control, Inc. for speaker fees.
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spelling pubmed-88229742022-02-18 4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort Black, Lauren Page Hopson, Charlotte DeVos, Elizabeth Fernandez, Rosemarie Guirgis, Faheem Garvan, Cynthia J Clin Transl Sci Clinical Epidemiology/Clinical Trial OBJECTIVES/GOALS: Septic shock is a lethal condition. Research suggests that overall sepsis mortality varies by race, but less is known about demographic differences in septic shock mortality. Our objectives were to describe the septic shock population using a large, state-wide data repository and identify demographic predictors of septic shock mortality. METHODS/STUDY POPULATION: This was a retrospective review of patients with septic shock in the One Florida Data Trust from 2012-2018. Patients were classified as having septic shock if they received vasopressors and had either 1) an ICD-9 or 10 code for septic shock or 2) an ICD-9 or 10 code for infection and an ICD-9 or 10 code for organ dysfunction. Demographic data and place of residence prior to admission was collected. The primary outcome was 90 day mortality. T-test and chi-square tests were used to test association of individual predictors and mortality. Multiple logistic regression was used to identify predictors of mortality after adjustment for other variables. Level of significance was set at 0.05. SAS v9.4 (Cary, NC) was used for analyses. RESULTS/ANTICIPATED RESULTS: There were 11,790 patients with septic shock. The mean(SD) age was 61(16) years. With regard to race/ethnicity 66% identified as white, 27% as black, 3.7% as Hispanic, and 3.5% as other races (non-white, non-black, non-Hispanic). Most came from home (57%). Overall, 39% died. Mortality varied by race (p<0.01): white 39%, black 39%, Hispanic 31%, other races 51%. In the logistic regression model, age, race, and residence were significant predictors of mortality, after adjustment for other variables. Each additional year of age had a 2.7% increased odds of mortality (OR 1.03; 95% CI 1.02-1.03; p<0.01). Compared to white patients, odds of death were 1.6 times higher for other races (95% CI 1.3-2.0; p <0.01) and non-significantly higher for black patients (OR 1.1; 95% CI 1.0-1.2; p = 0.05). Compared to those from home, odds of death were highest for those from a skilled nursing facility (OR 1.5; p<0.01). DISCUSSION/SIGNIFICANCE OF IMPACT: Patients who identified as other races had increased mortality from septic shock compared to white patients after adjusting for other variables. Septic shock mortality also increased with age and varied by residence. Further analyses are needed to examine racial disparities and control for comorbidities, severity of illness, and aspects of resuscitation. CONFLICT OF INTEREST DESCRIPTION: The authors report no conflicts of interest, except for Dr. Fernandez, who reports personal payment from Physio-Control, Inc. for speaker fees. Cambridge University Press 2020-07-29 /pmc/articles/PMC8822974/ http://dx.doi.org/10.1017/cts.2020.145 Text en © The Association for Clinical and Translational Science 2020 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Epidemiology/Clinical Trial
Black, Lauren Page
Hopson, Charlotte
DeVos, Elizabeth
Fernandez, Rosemarie
Guirgis, Faheem
Garvan, Cynthia
4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort
title 4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort
title_full 4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort
title_fullStr 4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort
title_full_unstemmed 4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort
title_short 4332 Septic Shock Epidemiology and Sociodemographic Predictors of Mortality: Results from One Florida Data Trust Cohort
title_sort 4332 septic shock epidemiology and sociodemographic predictors of mortality: results from one florida data trust cohort
topic Clinical Epidemiology/Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8822974/
http://dx.doi.org/10.1017/cts.2020.145
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