- Robert Preidt
- Posted December 15, 2020
When Sepsis Strikes Children, Black Kids More Likely to Die: Study
The risk of death from severe sepsis is much higher for Black children than for white or Hispanic children, U.S. researchers say.
Severe sepsis is a life-threatening immune system overreaction to an infection.
"Some of the disparities in outcomes from sepsis that we've identified related to race/ethnicity and socioeconomic position are alarming, but this analysis is an important step towards working out why they exist and what measures can be taken to address them," said study leader Dr. Hannah Mitchell, a pediatric resident at Children's Hospital of Philadelphia (CHOP). Her team according published the study in The Lancet Child & Adolescent Health journal.
"Importantly, no differences in survival were seen between publicly and privately insured children," Mitchell noted in a journal news release.
In their research, the study authors analyzed data on more than 9,800 U.S. children hospitalized with severe sepsis in 2016. Most of the children were white (47.6%), followed by Hispanics (25.5%) and Blacks (16.9%).
The overall death rate was 14.6%, but the rate was significantly higher among Blacks (18.4%) than among Hispanics (13.7%) or whites (13.4%).
After accounting for a number of other factors, the researchers concluded that Black children were nearly 20% more likely to die than whites,
The higher risk of death for Black children was driven by higher rates in the West and South. In the West, Black children were nearly 60% more likely to die than whites. In the South, Black children's risk was 30% higher.
More than half of the patients in the study were publicly insured, but private insurance was much more common among white children (51.8%) than among Black (22.9%) or Hispanic (20.4%) children.
White children were also far less likely (24.1%) to live in zip codes associated with the lowest incomes than Black children (52.9%) and Hispanic children (41.5%).
"Other" insurance (self-pay, no charge and other) was associated with a 30% greater risk of death compared to public insurance.
Hospital stays for Black and Hispanic children averaged two days longer than for white children (10 compared with eight).
The findings are another stark example of the health disparities in the United States, according to the researchers.
"There is growing evidence that structural racism may be an important factor in the social and economic conditions that ultimately lead to health inequalities in children," said study senior author Dr. Nadir Yehya, an attending physician at CHOP's Pediatric Sepsis Program and the Division of Critical Care Medicine. "Our findings demonstrate a need to examine the different ways in which these biases may contribute at structural, interpersonal or individualized levels to sepsis outcomes in children."
The U.S. National Institute of General Medical Sciences has more on sepsis.
SOURCE: The Lancet Child & Adolescent Health, news release, Dec. 14, 2020