Nasrullah Adeel, Quazi Mohammed A, Shakir Muhammad Hassan, Khan Eiraj, Sohail Amir H, Bilal Muhammad Ibraiz, Muzammil Taimur, Sheikh Abu Baker, Adrish Muhammad, Cheema Tariq
Division of Pulmonary and Critical Care, Allegheny Health Network, Pittsburgh, PA, USA.
Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
J Gen Intern Med. 2025 Apr 14. doi: 10.1007/s11606-025-09501-x.
The mortality rate and outcomes of septic shock can vary, depending on the patient's race. The most comprehensive national study on these racial disparities is dated, and recent studies have reported mixed findings.
To gain insight into racial variation in outcomes of septic shock and understand underlying factors.
A retrospective analysis using National Inpatient Sample data (2016-2020). Patients were grouped by race, and patient and hospital characteristics, outcomes, and complications were compared. Multivariable logistic regression analyses were conducted.
Hospitalized patients aged ≥ 18 years with septic shock.
In-hospital mortality, mechanical ventilation, vasopressor use, acute kidney injury, need for hemodialysis, acute myocardial infarction, requirement for blood transfusion, length of stay, the financial burden on healthcare, and resource utilization.
Among 2,789,890 patients, 67.5% were White, 14.4% Black, 10.9% Hispanic, 3.3% Asian or Pacific Islander, and 0.8% Native American; 46.2% were aged > 70 years. Compared to White patients, Black patients had 23% higher odds of mortality (adjusted odds ratio [aOR] 1.23, 95% CI 1.21-1.25) and the highest odds of invasive mechanical ventilation (aOR 1.42) and hemodialysis (aOR 1.96). Native American patients had the highest odds of acute respiratory distress syndrome (aOR 2.03), while Asian or Pacific Islander patients had increased odds of blood transfusions (aOR 1.52). Palliative care consultations were less common among Asian, Black, and Hispanic patients compared to White patients.
Racial disparities persist in septic shock outcomes, with higher mortality and complications among Black, Hispanic, Asian, and Native American patients, along with less utilization of palliative care services compared to White patients.
感染性休克的死亡率和预后可能因患者种族而异。关于这些种族差异的最全面的全国性研究已过时，最近的研究报告结果不一。
深入了解感染性休克预后的种族差异并了解潜在因素。
使用国家住院患者样本数据（2016 - 2020年）进行回顾性分析。患者按种族分组，比较患者和医院特征、预后及并发症。进行多变量逻辑回归分析。
年龄≥18岁的感染性休克住院患者。
住院死亡率、机械通气、血管活性药物使用、急性肾损伤、血液透析需求、急性心肌梗死、输血需求、住院时间、医疗保健的经济负担以及资源利用情况。
在2,789,890名患者中，67.5%为白人，14.4%为黑人，10.9%为西班牙裔，3.3%为亚裔或太平洋岛民，0.8%为美国原住民；46.2%年龄>70岁。与白人患者相比，黑人患者的死亡几率高23%（调整优势比[aOR]1.23，95%置信区间1.21 - 1.25），有创机械通气几率最高（aOR 1.42），血液透析几率最高（aOR 1.96）。美国原住民患者发生急性呼吸窘迫综合征的几率最高（aOR 2.03），而亚裔或太平洋岛民患者输血几率增加（aOR 1.52）。与白人患者相比，亚裔、黑人和西班牙裔患者接受姑息治疗会诊的情况较少。
感染性休克预后的种族差异仍然存在，黑人、西班牙裔、亚裔和美国原住民患者的死亡率和并发症较高，与白人患者相比，姑息治疗服务的利用率较低。
