The Association of Race and Survival from Sepsis after Injury

• Published in: The American surgeon Vol. 76; no. 1; pp. 43 - 47
• Main Authors: PLURAD, David S, LUSTENBERGER, Thomas, KILDAY, Patrick, ZHU, Jay, GREEN, Donald J, INABA, Kenji, TALVING, Peep, BELZBERG, Howard, DEMETRIADES, Demetrios
• Format: Journal Article
• Language: English
• Published: Atlanta, GA Southeastern Surgical Congress 2010; SAGE PUBLICATIONS, INC
• Subjects: Adult; African Americans - statistics & numerical data; Asian Americans - statistics & numerical data; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Blood pressure; Clinical medicine; Confidence intervals; European Continental Ancestry Group - statistics & numerical data; Female; General aspects; Health care access; Hispanic Americans - statistics & numerical data; Human bacterial diseases; Humans; Incidence; Infectious diseases; Logistic Models; Los Angeles - epidemiology; Male; Medical sciences; Middle Aged; Mortality; Prospective Studies; Pulmonary arteries; Race; Respiratory distress syndrome; Sepsis; Sepsis - ethnology; Sepsis - etiology; Sepsis - mortality; Socioeconomic factors; Survival Rate; Wounds and Injuries - complications; Wounds and Injuries - ethnology; Wounds and Injuries - mortality; Los Angeles; Ethnic origin; Survival; Trauma; Bacteremia; Infection; Medicine; Sepsis syndrome; Association; Treatment; Surgery; Race; Bacteriosis; Lesion
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313481007600109

Genetic variation is associated with outcome disparity in critical illness. We sought to determine if race is independently associated with the development of posttraumatic sepsis and subsequent related mortality. Our Intensive Care Unit database was queried for admissions from January 1, 2000 to June 30, 2007. Patients were prospectively followed for sepsis (Any four of the following symptoms: temperature > or =38 degrees C, heart rate (HR) > or =90 b/m, RR > or =20 b/m (or PaCO2 < or =32 mm Hg), white blood cell count (WBC) > or =12, or vasopressor requirement all with an infectious source). White, Black, Hispanic, and Asian groups were defined. "Other" race was excluded. Most of the 3998 study patients were male (3157, 79.0%). Blunt trauma (2661, 66.6%) predominated. Six-hundred-seventy-seven (16.9%) met sepsis criteria. Mortality was 14.0 per cent (560). Sepsis was increased in Asians versus all others combined (23.7% vs. 16.1%). Race was independently associated with sepsis (adjusted odds ratio (OR) 1.12 (1.01-1.24), P value = 0.03). Sepsis associated mortality was 36.9 per cent (250/677). Black race demonstrated an increased survival versus all others after sepsis (25.4% vs. 37.7%) but this was not statistically significant (adjusted OR 0.96 (0.73-1.18), P value = 0.71). Race is independently associated with posttraumatic sepsis and possibly subsequent sepsis associated mortality. Further related study is needed with the ultimate goal of genetically based treatments for the prevention and treatment of sepsis after injury.