Association Between Neighborhood Socioeconomics and Mortality in Community-Acquired Sepsis

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Chest

Abstract

PURPOSE: Sepsis is a significant driver of mortality, with many patients presenting to emergency departments with widespread infections already acquired from outside the hospital. While sepsis-related mortality is multifactorial, the role of social determinants and socioeconomic status remains less explored. This study aimed to investigate the association between community-level socioeconomic status, as measured by the Area Deprivation Index (ADI), on sepsis-related mortality. METHODS: A retrospective chart analysis was conducted for 1,561 patients aged 18 years or older with sepsis onset within 24 hours of emergency department arrival between January and December 2023. Sepsis “time zero” was determined using an algorithm developed by our team to process structured clinical data as well as unstructured data with a rule-based natural language processing (NLP) approach. Multivariate linear regression including age, gender, race, ADI and 27 chronic conditions was performed using backward selection to determine variables that were significantly associated with 30-day mortality. RESULTS: Of the 1561 individuals with community acquired sepsis, 300 expired within 30 days, with a median age of 75 (IQR 65-83). Of those who expired, the majority were white (68%) and women (51%). In multivariate regression, acute myocardial infarction, atrial fibrillation, lung cancer, and chronic kidney disease (OR 1.66, 1.57, 1.81, and 1.59) were significantly associated with increased risk of mortality, whereas hyperplasia, hyperlipidemia, and rheumatoid arthritis (OR 0.65, 0.66, and 0.71) were significantly associated with decreased risk. In addition, there was a significant association between 30-day mortality and age (OR 1.03) and ADI quintile (OR 1.07), but not race or gender. CONCLUSIONS: The ADI is significantly associated with 30-day mortality after adjusting for age, chronic conditions, race, and gender. CLINICAL IMPLICATIONS: Socioeconomic factors contribute to the risk of mortality in community acquired sepsis.

Volume

168

Issue

4S

First Page

2177A

Last Page

2177A

Comments

American College of Chest Physicians CHEST Annual Meeting, October 19-22, 2025, Chicago, IL

DOI

10.1016/j.chest.2025.07.1252

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