Racial differences in mortality from severe acute respiratory failure in the United States, 2008-2012

Christian Bime, Chithra Poongkunran, Mark Borgstrom, Bhupinder Natt, Hem Desai, Sairam Parthasarathy, Joe GN Garcia

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Rationale: Racial disparities in health and healthcare in the United States are well documented and are increasingly recognized in acute critical illnesses such as sepsis and acute respiratory failure. Objectives: Using a large, representative, U.S. nationwide database, we examined the hypothesis that black and Hispanic patients with severe acute respiratory failure have higher mortality rates when compared with non-Hispanic whites. Methods: This retrospective analysis used discharge data from the Agency for Healthcare Research and Quality, Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, for the years 2008-2012. We identified hospitalizations with acute respiratory failure using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification, codes. A logistic regression model was fitted to compare in-hospital mortality rates by race. Measurements and Main Results: After adjusting for sex, age, race, disease severity, type of hospital, and median household income for patient ZIP code, blacks had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.11-1.14; P<0.001), and Hispanics also had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (OR, 1.17; 95% CI, 1.15-1.19; P<0.001), and so did Asian and Pacific Islanders (OR, 1.15; 95% CI, 1.12-1.18; P<0.001) and Native Americans (OR, 1.08; 95% CI, 1.00-1.15; P<0.001) when compared with non-Hispanic whites (OR, 1.0). Conclusions: Blacks, Hispanics, and other racial minorities in the United States were observed to exhibit significantly higher in-hospital sepsis-related respiratory failure associated mortality when compared with non-Hispanic whites.

Original languageEnglish (US)
Pages (from-to)2184-2189
Number of pages6
JournalAnnals of the American Thoracic Society
Volume13
Issue number12
DOIs
StatePublished - Dec 1 2016

Fingerprint

Respiratory Insufficiency
Odds Ratio
Mortality
Hispanic Americans
Confidence Intervals
Sepsis
Logistic Models
North American Indians
Health Services Research
International Classification of Diseases
Hospital Mortality
Critical Illness
Health Care Costs
Inpatients
Hospitalization
Databases
Delivery of Health Care
Health

Keywords

  • Ethnicity
  • Health disparities
  • Mortality
  • Race
  • Respiratory failure

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine

Cite this

Racial differences in mortality from severe acute respiratory failure in the United States, 2008-2012. / Bime, Christian; Poongkunran, Chithra; Borgstrom, Mark; Natt, Bhupinder; Desai, Hem; Parthasarathy, Sairam; Garcia, Joe GN.

In: Annals of the American Thoracic Society, Vol. 13, No. 12, 01.12.2016, p. 2184-2189.

Research output: Contribution to journalArticle

@article{a10f1c8b511947a6ad64401dd72c8997,
title = "Racial differences in mortality from severe acute respiratory failure in the United States, 2008-2012",
abstract = "Rationale: Racial disparities in health and healthcare in the United States are well documented and are increasingly recognized in acute critical illnesses such as sepsis and acute respiratory failure. Objectives: Using a large, representative, U.S. nationwide database, we examined the hypothesis that black and Hispanic patients with severe acute respiratory failure have higher mortality rates when compared with non-Hispanic whites. Methods: This retrospective analysis used discharge data from the Agency for Healthcare Research and Quality, Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, for the years 2008-2012. We identified hospitalizations with acute respiratory failure using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification, codes. A logistic regression model was fitted to compare in-hospital mortality rates by race. Measurements and Main Results: After adjusting for sex, age, race, disease severity, type of hospital, and median household income for patient ZIP code, blacks had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (odds ratio [OR], 1.13; 95{\%} confidence interval [CI], 1.11-1.14; P<0.001), and Hispanics also had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (OR, 1.17; 95{\%} CI, 1.15-1.19; P<0.001), and so did Asian and Pacific Islanders (OR, 1.15; 95{\%} CI, 1.12-1.18; P<0.001) and Native Americans (OR, 1.08; 95{\%} CI, 1.00-1.15; P<0.001) when compared with non-Hispanic whites (OR, 1.0). Conclusions: Blacks, Hispanics, and other racial minorities in the United States were observed to exhibit significantly higher in-hospital sepsis-related respiratory failure associated mortality when compared with non-Hispanic whites.",
keywords = "Ethnicity, Health disparities, Mortality, Race, Respiratory failure",
author = "Christian Bime and Chithra Poongkunran and Mark Borgstrom and Bhupinder Natt and Hem Desai and Sairam Parthasarathy and Garcia, {Joe GN}",
year = "2016",
month = "12",
day = "1",
doi = "10.1513/AnnalsATS.201605-359OC",
language = "English (US)",
volume = "13",
pages = "2184--2189",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
publisher = "American Thoracic Society",
number = "12",

}

TY - JOUR

T1 - Racial differences in mortality from severe acute respiratory failure in the United States, 2008-2012

AU - Bime, Christian

AU - Poongkunran, Chithra

AU - Borgstrom, Mark

AU - Natt, Bhupinder

AU - Desai, Hem

AU - Parthasarathy, Sairam

AU - Garcia, Joe GN

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Rationale: Racial disparities in health and healthcare in the United States are well documented and are increasingly recognized in acute critical illnesses such as sepsis and acute respiratory failure. Objectives: Using a large, representative, U.S. nationwide database, we examined the hypothesis that black and Hispanic patients with severe acute respiratory failure have higher mortality rates when compared with non-Hispanic whites. Methods: This retrospective analysis used discharge data from the Agency for Healthcare Research and Quality, Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, for the years 2008-2012. We identified hospitalizations with acute respiratory failure using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification, codes. A logistic regression model was fitted to compare in-hospital mortality rates by race. Measurements and Main Results: After adjusting for sex, age, race, disease severity, type of hospital, and median household income for patient ZIP code, blacks had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.11-1.14; P<0.001), and Hispanics also had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (OR, 1.17; 95% CI, 1.15-1.19; P<0.001), and so did Asian and Pacific Islanders (OR, 1.15; 95% CI, 1.12-1.18; P<0.001) and Native Americans (OR, 1.08; 95% CI, 1.00-1.15; P<0.001) when compared with non-Hispanic whites (OR, 1.0). Conclusions: Blacks, Hispanics, and other racial minorities in the United States were observed to exhibit significantly higher in-hospital sepsis-related respiratory failure associated mortality when compared with non-Hispanic whites.

AB - Rationale: Racial disparities in health and healthcare in the United States are well documented and are increasingly recognized in acute critical illnesses such as sepsis and acute respiratory failure. Objectives: Using a large, representative, U.S. nationwide database, we examined the hypothesis that black and Hispanic patients with severe acute respiratory failure have higher mortality rates when compared with non-Hispanic whites. Methods: This retrospective analysis used discharge data from the Agency for Healthcare Research and Quality, Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, for the years 2008-2012. We identified hospitalizations with acute respiratory failure using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification, codes. A logistic regression model was fitted to compare in-hospital mortality rates by race. Measurements and Main Results: After adjusting for sex, age, race, disease severity, type of hospital, and median household income for patient ZIP code, blacks had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.11-1.14; P<0.001), and Hispanics also had a greater odds ratio of in-hospital death when compared with non-Hispanic whites (OR, 1.17; 95% CI, 1.15-1.19; P<0.001), and so did Asian and Pacific Islanders (OR, 1.15; 95% CI, 1.12-1.18; P<0.001) and Native Americans (OR, 1.08; 95% CI, 1.00-1.15; P<0.001) when compared with non-Hispanic whites (OR, 1.0). Conclusions: Blacks, Hispanics, and other racial minorities in the United States were observed to exhibit significantly higher in-hospital sepsis-related respiratory failure associated mortality when compared with non-Hispanic whites.

KW - Ethnicity

KW - Health disparities

KW - Mortality

KW - Race

KW - Respiratory failure

UR - http://www.scopus.com/inward/record.url?scp=85007449391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007449391&partnerID=8YFLogxK

U2 - 10.1513/AnnalsATS.201605-359OC

DO - 10.1513/AnnalsATS.201605-359OC

M3 - Article

VL - 13

SP - 2184

EP - 2189

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 12

ER -