{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:49:39Z","timestamp":1790758179897,"version":"4.1.0"},"reference-count":28,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,18]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Social determinants of health (SDOH) factors are known to influence patient outcomes, but their effect on sepsis remains insufficiently studied. This research aims to investigate the relationship between SDOH factors and sepsis outcomes, highlighting opportunities to reduce health disparities and enhance patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Level I trauma centre in Baton Rouge, Louisiana, USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with sepsis aged 18\u201389 years. Patients discharged or transferred to hospice were excluded to prevent bias and misinterpretation of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main exposure measures<\/jats:title>\n                    <jats:p>Social Vulnerability Index (SVI), the Gini Index and the average distance to the nearest urgent care, emergency department and clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>In-hospital mortality, 30-day readmission and hospital length of stay (LOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests, Mann-Whitney U tests and Cox regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Distance from urgent care is significantly associated with mortality (4.14 vs 3.24 miles, p&lt;0.001). Higher SVI is significantly associated with longer LOS (HR=0.846, 95%\u2009CI 0.743 to 0.963, p=0.011). Distance from urgent care is also significantly associated with a longer LOS (HR=0.991, 95%\u2009CI 0.986 to 0.996, p=0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mortality and LOS are closely linked to proximity to urgent care, while high SVI is notably associated with longer LOS. These findings highlight the significant impact of SDOH factors on sepsis outcomes and underscore the need for targeted interventions to address disparities in healthcare access and contextual health practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102064","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T16:15:38Z","timestamp":1760372138000},"page":"e102064","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of social determinants of health on sepsis outcomes: a retrospective study of a single centre in the USA"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7767-2479","authenticated-orcid":false,"given":"Mwembezi A","family":"Nyelele","sequence":"first","affiliation":[{"name":"Mechanical and Industrial Engineering, Louisiana State University and Agricultural & Mechanical College, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Estela","sequence":"additional","affiliation":[{"name":"Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya","family":"Jagneaux","sequence":"additional","affiliation":[{"name":"Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura H","family":"Ikuma","sequence":"additional","affiliation":[{"name":"Mechanical and Industrial Engineering, Louisiana State University and Agricultural & Mechanical College, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald M","family":"Knapp","sequence":"additional","affiliation":[{"name":"Mechanical and Industrial Engineering, Louisiana State University and Agricultural & Mechanical College, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"2025120415063909000_15.10.e102064.1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.hrtlng.2021.02.014","article-title":"Lower socioeconomic factors are associated with higher mortality in patients with septic shock","volume":"50","author":"Colon Hidalgo","year":"2021","journal-title":"Heart Lung"},{"key":"2025120415063909000_15.10.e102064.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-043352","article-title":"Mid-German Sepsis Cohort (MSC): a prospective observational study of sepsis survivorship","volume":"11","author":"Fleischmann-Struzek","year":"2021","journal-title":"BMJ Open"},{"key":"2025120415063909000_15.10.e102064.3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7234a3"},{"key":"2025120415063909000_15.10.e102064.4","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-019-2522-6","article-title":"Health inequities in the diagnosis and outcome of sepsis in Argentina: a prospective cohort study","volume":"23","author":"Estenssoro","year":"2019","journal-title":"Crit Care"},{"key":"2025120415063909000_15.10.e102064.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-039146","article-title":"Social determinants of health associated with the development of sepsis in adults: a scoping review protocol","volume":"10","author":"Machon","year":"2020","journal-title":"BMJ Open"},{"key":"2025120415063909000_15.10.e102064.6","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.amjmed.2020.06.044","article-title":"Impact of Malnutrition on Hospitalization Outcomes for Older Adults Admitted for Sepsis","volume":"134","author":"Abugroun","year":"2021","journal-title":"Am J Med"},{"key":"2025120415063909000_15.10.e102064.7","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-048476","article-title":"Association between cytokine levels, sepsis severity and clinical outcomes in sepsis: a quantitative systematic review protocol","volume":"11","author":"Gharamti","year":"2021","journal-title":"BMJ Open"},{"key":"2025120415063909000_15.10.e102064.8","article-title":"Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis","volume":"6","author":"Webb","year":"2024","journal-title":"Crit Care Explor"},{"key":"2025120415063909000_15.10.e102064.9","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1097\/CCM.0000000000004307","article-title":"The Association Between Neighborhood Socioeconomic Disadvantage and Readmissions for Patients Hospitalized With Sepsis","volume":"48","author":"Galiatsatos","year":"2020","journal-title":"Crit Care Med"},{"key":"2025120415063909000_15.10.e102064.10","unstructured":"World Health Organization . 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