Key result
Black patients have higher postoperative sepsis risk but ~29% lower failure-to-rescue odds versus White patients.
Why the study?
Sepsis disproportionately affects marginalized communities, prompting evaluation of racial and ethnic disparities in failure-to-rescue after postoperative sepsis.
Are there racial and ethnic disparities in failure-to-rescue after postoperative sepsis following noncardiac surgery?
Cross-Sectional (n=1,388,977)
Yes
Are there racial and ethnic disparities in failure-to-rescue after postoperative sepsis following noncardiac surgery?
Effect estimate: aOR 0.71 (95% CI 0.54-0.94)
p-value: p=.017
Although Black and Hispanic individuals have higher rates of postoperative sepsis, they do not experience higher rates of failure-to-rescue compared to White individuals.
Disparities in postoperative sepsis do not extend to higher failure-to-rescue; this observational finding leaves open mechanisms and requires prospective validation.
BACKGROUND: Sepsis disproportionately affects marginalized communities. This study aims to evaluate racial and ethnic disparities in failure-to-rescue (FTR) after postoperative sepsis. METHODS: This cross-sectional study used data from the American College of Surgeons National Surgical Quality Improvement Program for patients who underwent inpatient noncardiac surgery between 2018 and 2021. Patients were categorized as non-Hispanic White (hereafter, White), non-Hispanic Black (hereafter, Black), Asian, and Hispanic individuals. The association between (1) FTR after sepsis and (2) FTR after septic shock and race and ethnicity was evaluated using multivariable logistic regression. Failure-to-rescue was defined as 30-day mortality among patients who developed postoperative sepsis or postoperative septic shock. RESULTS: Among the 1388,977 patients (mean [SD] age 60.5 [16]); 783,056 (56.4%) were female, 1017,875 (73%) were White, 171,774 (12%) were Black, 138,457 (10%) were Hispanic, and 60,871 (4%) were Asian. Compared to White individuals, Black (adjusted odds ratio [aOR], 1.29; 95% CI, 1.23-1.35, P < .001) and Hispanic individuals (aOR, 1.15; 95% CI, 1.09-1.21, P < .001) were more likely to develop sepsis; Black individuals were more likely to develop septic shock (aOR, 1.28; 95% CI, 1.21-1.36; P < .001), and Asians were less likely to develop septic shock (aOR 0.84; 95% CI, 0.75-0.93, P = .002). Black individuals experienced lower rates of FTR after sepsis [Black: (aOR, 0.71; 95% CI, 0.54-0.94; P = .017), while Black (aOR, 0.93; 95% CI, 0.80-1.08; P = .35)], Hispanic (aOR, 0.87; 95% CI, 0.72-1.06; P = .16) and Asian Individuals (aOR, 1.06; 95% CI, 0.8-1.37; P = .67) experienced similar rates of FTR after septic shock compared to White individuals. CONCLUSIONS: Black and Hispanic individuals experienced higher rates of postoperative sepsis but did not experience higher rates of failure-to-rescue. Reducing inequity in surgical care should focus on efforts to prevent postoperative sepsis.
No takes yet. Share an insight, caveat, or question.
Laserna et al. (2024) conducted a cross-sectional in Postoperative sepsis after noncardiac surgery (n=1,388,977). Non-White race and ethnicity (Black, Hispanic, Asian) vs. White race and ethnicity was evaluated on Failure-to-rescue (30-day mortality) after postoperative sepsis (aOR 0.71, 95% CI 0.54-0.94, p=.017). Black and Hispanic patients had higher odds of postoperative sepsis than White patients, but Black patients had lower odds of failure-to-rescue after sepsis (aOR 0.71; 95% CI 0.54-0.94; P=0.017).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: