CHICAGO (Reuters) - Blacks get severe sepsis -- a rampant infection of the bloodstream that causes organ failure -- at nearly twice the rate of whites, and they are far more likely to die from it, U.S. researchers said on Friday.
By Julie Steenhuysen
CHICAGO (Reuters) - Blacks get severe sepsis -- a rampant infection of the bloodstream that causes organ failure -- at nearly twice the rate of whites, and they are far more likely to die from it, U.S. researchers said on Friday.
They said poverty and hospital quality play a role, but it may also be that blacks are more susceptible to sepsis.
"Blacks do indeed have a higher rate of severe sepsis -- almost double that of whites," said Dr. Amber Barnato of the Center for Research on Health Care at the University of Pittsburgh.
!ADVERTISEMENT!"Some of the difference in incidence is due to social determinants -- things that are under the control of society," she said in a telephone interview.
"The flip side is that we didn't explain away all of the differences," said Barnato, whose study appears in the American Journal of Respiratory and Critical Care Medicine.
More than 750,000 Americans contract sepsis each year and a third to one half of those die from it. Sepsis is the 10th leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention.
It occurs when the body's immune system goes haywire in response to a bacterial infection, causing small blood clots to form that choke off blood flow to the body's vital organs. It is usually treated with intravenous antibiotics and fluids in a hospital intensive care unit.
Infants, the elderly and those with compromised immune systems are most at risk, but prior studies have found that race plays a significant role in determining who gets sepsis and who dies from it. Barnato and colleagues undertook a massive study of the problem in order to spot trends that could explain this difference.
They evaluated the hospital discharge records and U.S. census data of more than 71 million people in Florida, Massachusetts, New Jersey, New York, Virginia and Texas.
After controlling for age and gender, the researchers found blacks had the highest rate of acquiring the infection, at a rate of 6.08 cases per every 1,000 people. Whites got the infection at a rate of 3.58 cases per every 1,000 people.
After adjusting for poverty and city urban living, Hispanics had a lower incidence of sepsis than whites.
Blacks had the highest death rates from sepsis compared with whites or Hispanics. Blacks also were less likely to be treated in an intensive care unit, and if they were, they were more likely to die there than people in the other groups.
The researchers said the higher rates of infection among blacks may suggest biological differences in susceptibility.
"The incidence occurred as early as age 20. We know that young people don't have many chronic health problems. That makes us think that there may be some biologic susceptibility that is different in blacks compared with whites," Barnato said. "If we could figure that out, we can potentially improve treatments that are more specific to the biology of different races."
However, the researchers noted that blacks more often were treated in large, urban, teaching hospitals, where patients tend to be sicker, which could be a factor. And it may also reflect poor quality of care delivered in hospitals that treat a disproportionate number of blacks.
Barnato said efforts to improve quality of care in these hospitals may go far to improve death rates among blacks from this infection.
(Editing by Eric Walsh)
