773: Impact of Patient Demographics and Social Drivers of Health on Mortality in Patients With Sepsis

Introduction: Demographic factors and social drivers of health (SDoH) influence overall patient health. There are conflicting data on the impact of these factors on mortality rates in sepsis. SEP-1 is a compliance measure used to evaluate achievement of specific early interventions by hospitals, in which higher compliance is associated with lower mortality. Methods: This is a retrospective, observational cohort study of all adult patients with sepsis admitted to a 427-bed community teaching hospital between March-July 2024. Primary outcome was mortality and secondary outcome was SEP-1 bundle compliance. Outcomes were compared across age, race, gender, high and low risk SDoH groups using Chi-squared, two-sided t-test, or Mann-Whitney U tests, as appropriate, with p< 0.05 indicating significance. SDoH risk was based on 14 SDoH variables (e.g., financial strain, transportation, health literacy) with patients exceeding the median number of SDoH risk factors defined as high risk. Results: The 349 total patients were 54.4% aged 65 years or older; 74.5% white, 20.9% black, and 4.6% other/unknown race; and 48.7% male. The median number of SDoH risk factors was 8, most commonly tobacco use (n=185), lack of established PCP (n=65), and financial strain (n=28). There was no difference in mortality when compared across age, race, or gender. Mortality was higher in patients with low SDoH versus high SDoH risk (9.2% vs 3.6%, p=0.033). No statistically significant differences in SEP-1 bundle compliance were observed across gender (p=0.329) or age (p=0.203). There was a significant difference in 100% SEP-1 bundle compliance between races (white 67.3%, black 75.3%, other/unknown 68.8%, p< 0.001). For SDoH, overall SEP-1 bundle compliance was high (mean 90±17%) and was similar for patients with low (n=183) and high (n=166) SDoH risk (89±18% vs 90±16%, p=0.855). Conclusions: Age, race, and gender did not impact mortality in patients with sepsis. High SDoH risk was associated with lower mortality. SEP-1 bundle compliance was similar across all groups, except black patients had higher 100% compliance. Results are limited by small sample size and incomplete documentation, but highlight complexities between disparities and patient outcomes. Ongoing research will evaluate a larger cohort to identify potential risk groups.