TY - JOUR
T1 - Linking Sepsis with chronic arterial hypertension, diabetes mellitus, and socioeconomic factors in the United States
T2 - A scoping review
AU - Ahlberg, Caitlyn D.
AU - Wallam, Sara
AU - Tirba, Lemya A.
AU - Itumba, Stephanie N.
AU - Gorman, Linda
AU - Galiatsatos, Panagis
N1 - Funding Information:
The authors would like to thank Dr. Emily Gao for her support and guidance on this paper.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/10
Y1 - 2023/10
N2 - Rationale: Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host immune response to infection. Social risk factors including location and poverty are associated with sepsis-related disparities. Understanding the social and biological phenotypes linked with the incidence of sepsis is warranted to identify the most at-risk populations. We aim to examine how factors in disadvantage influence health disparities related to sepsis. Methods: A scoping review was performed for English-language articles published in the United States from 1990 to 2022 on PubMed, Web of Science, and Scopus. Of the 2064 articles found, 139 met eligibility criteria and were included for review. Results: There is consistency across the literature of disproportionately higher rates of sepsis incidence, mortality, readmissions, and associated complications, in neighborhoods with socioeconomic disadvantage and significant poverty. Chronic arterial hypertension and diabetes mellitus also occur more frequently in the same geographic distribution as sepsis, suggesting a potential shared pathophysiology. Conclusions: The distribution of chronic arterial hypertension, diabetes mellitus, social risk factors associated with socioeconomic disadvantage, and sepsis incidence, are clustered in specific geographical areas and linked by endothelial dysfunction. Such population factors can be utilized to create equitable interventions aimed at mitigating sepsis incidence and sepsis-related disparities.
AB - Rationale: Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host immune response to infection. Social risk factors including location and poverty are associated with sepsis-related disparities. Understanding the social and biological phenotypes linked with the incidence of sepsis is warranted to identify the most at-risk populations. We aim to examine how factors in disadvantage influence health disparities related to sepsis. Methods: A scoping review was performed for English-language articles published in the United States from 1990 to 2022 on PubMed, Web of Science, and Scopus. Of the 2064 articles found, 139 met eligibility criteria and were included for review. Results: There is consistency across the literature of disproportionately higher rates of sepsis incidence, mortality, readmissions, and associated complications, in neighborhoods with socioeconomic disadvantage and significant poverty. Chronic arterial hypertension and diabetes mellitus also occur more frequently in the same geographic distribution as sepsis, suggesting a potential shared pathophysiology. Conclusions: The distribution of chronic arterial hypertension, diabetes mellitus, social risk factors associated with socioeconomic disadvantage, and sepsis incidence, are clustered in specific geographical areas and linked by endothelial dysfunction. Such population factors can be utilized to create equitable interventions aimed at mitigating sepsis incidence and sepsis-related disparities.
KW - Chronic arterial hypertension
KW - Diabetes mellitus
KW - Endothelial dysfunction
KW - Health disparities
KW - Poverty
KW - Sepsis
KW - Socioeconomic disadvantage
KW - Socioeconomic status
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U2 - 10.1016/j.jcrc.2023.154324
DO - 10.1016/j.jcrc.2023.154324
M3 - Review article
C2 - 37159971
AN - SCOPUS:85156140951
SN - 0883-9441
VL - 77
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154324
ER -