Migrants with precarious status (MPS) with sepsis had a significantly lower hazard of 90-day mortality compared to non-MPS patients (HR 0.36; 95% CI 0.14-0.90; p=0.03).
Cohort (n=154)
Yes
Does migrant with precarious status (MPS) affect 90-day mortality in patients with sepsis?
Migrants with precarious status diagnosed with sepsis had a significantly lower 90-day mortality and higher post-discharge health system engagement compared to age-matched non-MPS patients.
Effect estimate: HR 0.36 (95% CI 0.14-0.90)
p-value: p=0.03
Abstract Rationale Sepsis, characterized by life-threatening organ dysfunction, is a costly and deadly health problem which accounts for almost 20% of all global deaths and remains one of the most common causes of in-hospital mortality in the United States. In the US, migrants and refugees are one of the most vulnerable groups as they are affected by socioeconomic disparities with added layer of complexity due to their migration status. Over 10 million ‘Migrants with precarious status’ (MPS), defined as undocumented migrants, refugee and asylum seekers, live in the United States. However, outcomes for important health conditions, such as sepsis, are poorly studied in this vulnerable population. Methods We conducted a multi-center retrospective cohort study, at quaternary academic medical center and urban safety-net hospital, of patients with diagnosis of sepsis between January 2021 and December 2023. Patients who received Medicaid insurance or County Medical Services were included. Electronic health records were manually reviewed to identify migration status. MPS patients were then aged-matched 1:1 with non-MPS patients who also received Medicaid insurance or County Medical Services. Primary outcome includes 90-day mortality. Secondary outcomes include in-hospital outcomes (ICU admission, need for mechanical ventilation, administration of vasopressors) and post-discharge outcomes (readmission at the Health System, engagement with or outside the Health System within 90 days). Results 77 MPS patients (47.2 ± 12.8 years old, 69% male, predominantly Spanish-speaking) were identified. MPS status was associated with a lower hazard of 90-day mortality (HR = 0.36, 95% CI: 0.14-0.90, p = 0.03). MPS patients were more likely to engage with the Health System post-discharge (MPS 71% vs non-MPS 52%, p-value = 0.03). There were no significant differences between in-hospital outcomes (ICU admission, mechanical ventilation, administration of vasopressors) and MPS status. Conclusion Results emphasize the importance of arranging proper follow-up with recognition that most of the MPS patients are not usually lost to follow-up, and MPS status is associated with survival benefit. Further investigations are required to validate these observations and expand our understanding of this vulnerable population. This abstract is funded by: None
Kyaw et al. (Fri,) conducted a cohort in Sepsis (n=154). Migrants with precarious status (MPS) vs. Non-MPS patients was evaluated on 90-day mortality (HR 0.36, 95% CI 0.14-0.90, p=0.03). Migrants with precarious status (MPS) with sepsis had a significantly lower hazard of 90-day mortality compared to non-MPS patients (HR 0.36; 95% CI 0.14-0.90; p=0.03).