Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
Deptartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
J Epidemiol Community Health. 2023 Mar;77(3):168-174. doi: 10.1136/jech-2022-219825. Epub 2023 Jan 27.
Socioeconomic status (SES) may influence risk of sepsis and sepsis-related mortality, but to what extent lifestyle and health-related factors mediate this effect is not known.
The study included 65 227 participants of the population-based HUNT Study in Norway linked with hospital records to identify incident sepsis and sepsis-related deaths. Cox regression estimated HRs of sepsis risk and mortality associated with different indicators of SES, whereas mediation analyses were based on an inverse odds weighting approach.
During ~23 years of follow-up (1.3 million person-years), 4200 sepsis cases and 1277 sepsis-related deaths occurred. Overall, participants with low SES had a consistently increased sepsis risk and sepsis-related mortality using education, occupational class and financial difficulties as indicators of SES. Smoking and alcohol consumption explained 57% of the sepsis risk related to low education, whereas adding risk factors of cardiovascular disease and chronic diseases to the model increased the explained proportion to 78% and 82%, respectively.
This study shows that SES is inversely associated with sepsis risk and mortality. Approximately 80% of the effect of education on sepsis risk was explained by modifiable lifestyle and health-related factors that could be targets for prevention.
社会经济地位（SES）可能会影响脓毒症和脓毒症相关死亡率的风险，但生活方式和与健康相关的因素在多大程度上影响这种影响尚不清楚。
该研究纳入了挪威基于人群的 HUNT 研究中的 65227 名参与者，并与医院记录相关联，以确定是否发生脓毒症和脓毒症相关死亡。Cox 回归估计了不同 SES 指标与脓毒症风险和死亡率相关的 HR，而中介分析则基于逆概率加权法。
在大约 23 年的随访期间（130 万人年），发生了 4200 例脓毒症病例和 1277 例脓毒症相关死亡。总体而言，SES 较低的参与者发生脓毒症的风险和脓毒症相关死亡率持续升高，使用教育、职业阶层和经济困难作为 SES 的指标。吸烟和饮酒分别解释了低教育相关脓毒症风险的 57%，而将心血管疾病和慢性疾病的危险因素纳入模型后，解释比例分别增加到 78%和 82%。
本研究表明，SES 与脓毒症风险和死亡率呈负相关。教育对脓毒症风险的影响约有 80%可以通过可改变的生活方式和与健康相关的因素来解释，这些因素可能是预防的目标。
