Racial Disparities in Septic Shock Outcomes: A Nationwide Analysis (2016-2020).

Summary

Using 2.79 million U.S. hospitalizations (2016–2020), this study shows higher in-hospital mortality and complications for Black, Hispanic, Asian/Pacific Islander, and Native American patients with septic shock versus White patients, with lower palliative care use among minority groups. Findings underscore systemic inequities in care and outcomes.

Key Findings

• Among 2,789,890 septic shock hospitalizations, Black patients had higher mortality (aOR 1.23, 95% CI 1.21–1.25) than White patients.
• Black patients had the highest odds of invasive mechanical ventilation (aOR 1.42) and hemodialysis (aOR 1.96).
• Native American patients had the highest odds of ARDS (aOR 2.03); Asian/Pacific Islander patients had increased blood transfusion odds (aOR 1.52).
• Palliative care consultations were less common among Asian, Black, and Hispanic patients compared with White patients.

Clinical Implications

Hospitals should implement equity-focused sepsis pathways, ensure timely escalation and palliative care access for minority patients, and monitor outcomes by race/ethnicity to reduce disparities.

Limitations

• Administrative data prone to coding misclassification and residual confounding
• Limited clinical granularity (e.g., illness severity, timing of interventions)

Future Directions

Link administrative data with clinical registries to adjust for illness severity; evaluate targeted interventions to reduce disparities and improve palliative care uptake.