{
  "abstract": "Objectives Socioeconomic inequalities exist in infectious diseases and sepsis in high-income countries. We investigated the association between income and mortality among patients with sepsis, overall and among those treated in the intensive care unit (ICU) versus general wards.Design A retrospective register-based cohort study.Setting The Region of Southern Denmark (RSD).Participants All adult patients with an unplanned contact with a hospital in the RSD from 1 January 2016 to 20 March 2018. Patients with sepsis were identified based on the following criteria: (1) blood culture(s) performed within 48 hours of arrival, (2) antibiotic(s) administered within 48 hours of arrival, (3) a discharge diagnosis of infection and (4) a SOFA (Sequential Organ Failure Assessment) score of ≥2. The cohort was divided into quartiles according to household income.Primary and secondary outcome measures Cox proportional hazards models were used to estimate the association between income groups and mortality. The primary outcome was 90-day mortality with 7-day and 365-day mortality as secondary outcomes. All outcomes were calculated overall and stratified by general ward treatment only and ICU admission.Results We identified 7813 first-time visits with community-acquired sepsis, including 886 ICU admissions (11.3%). Among patients in the lowest income group, sepsis was associated with a HR of 1.16 (95% CI 1.01 to 1.34) for 90-day mortality compared with the highest income group. This association was particularly pronounced at 365-day follow-up: HR=1.24 (95% CI 1.10 to 1.39). No difference was observed in 7-day all-cause mortality, HR=1.13 (95% CI 0.89 to 1.45). The association was not observed among patients admitted to the ICU.Conclusion Low income was associated with increased mortality in patients with sepsis, particularly during long-term follow-up. The impact of income disparities was not observed among patient admitted to the ICU.",
  "authors": [
    {
      "affiliations": [
        "Department of Emergency Medicine, Odense University Hospital, Odense, Region of Southern Denmark, Denmark",
        "Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Camilla Schade Skov"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Odense University Hospital, Odense, Region of Southern Denmark, Denmark",
        "Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark",
        "Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Hong Kong, Hong Kong"
      ],
      "name": "Mikkel Brabrand"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands",
        "Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Central Denmark Region, Denmark"
      ],
      "name": "Bas de Groot"
    },
    {
      "affiliations": [
        "Department of Clinical Microbiology, Odense University Hospital, Odense, Region of Southern Denmark, Denmark",
        "Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Flemming Schønning Rosenvinge"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, University Hospital of Southern Denmark, Aabenraa, Region of Southern Denmark, Denmark",
        "Department of Regional Health Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Helene Skjøt-Arkil"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, University Hospital of Southern Denmark, Aabenraa, Region of Southern Denmark, Denmark",
        "Department of Regional Health Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Christian Backer Mogensen"
    },
    {
      "affiliations": [
        "Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark",
        "Department of Infectious Diseases, Odense University Hospital, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Isik Somuncu Johansen"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Odense University Hospital, Odense, Region of Southern Denmark, Denmark",
        "Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Annmarie Touborg Lassen"
    }
  ],
  "title": "Socioeconomic disparities and mortality among acute patients with sepsis: a retrospective Danish cohort study",
  "uid": "d8fc9c3e-0663-512e-ac26-bf47355d9e30"
}