{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:53:41Z","timestamp":1764057221557,"version":"3.45.0"},"reference-count":85,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"crossref","award":["K24HL160527"],"award-info":[{"award-number":["K24HL160527"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NIHMDS","award":["F32MD019534"],"award-info":[{"award-number":["F32MD019534"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,11]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Racial disparities in critical illness outcomes are well-described, with social determinants of health as likely contributors. We sought to identify inequalities in readmissions and mortality between black and white patients among survivors of critical illness with sepsis and assess whether these disparities were explained by neighbourhood characteristics, health insurance and hospital quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study examining 90-day and 9-month readmissions and survival as coprimary outcomes. Models included age, sex, race and area deprivation index (ADI), Medicaid status or hospital Centers for Medicare &amp; Medicaid Star rating. Accelerated failure time and Cox proportional hazards models with subgroup analyses by age and surgical status were employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>14 community and tertiary hospitals in Western Pennsylvania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>48 027 survivors of sepsis with critical illness; 20 952 (50.4%) male; 6489 (13.5%) identified as black.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Black patients were younger (mean age 59.0 years vs 65.8 years), more likely to have higher ADI, Medicaid insurance and receive care at lower-quality hospitals. Black patients had higher readmission risk: (90-day subdistribution HR (SDHR) 1.13 (95% CI 1.04 to 1.23); p=0.003); 9-month SDHR: 1.11 (95% CI 1.03 to 1.20); p=0.005). Adjusting for age and sex, we found no difference in 90-day and 9-month mortality (90-day acceleration factor (AF): 1.04 (95% CI 0.91 to 1.19); p=0.556; 9-month: 1.08 (95% CI 0.96 to 1.22); p=0.196), which remained consistent when including ADI, Medicaid status or hospital quality. Mortality among black patients was increased relative to white patients among patients \u226560 years (9-month AF 1.23 (95% CI 1.07 to 1.42; p=0.004)) and among surgical patients (90-day AF: 1.23 (95% CI 1.01 to 1.50; p=0.04); 9-month AF: 1.28 (95% CI 1.07 to 1.53; p=0.006)). Medicaid status, but not ADI or hospital quality, attenuated racial differences in subgroup mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a retrospective analysis of intensive care unit (ICU) survivors with sepsis, black patients had higher readmission rates but comparable mortality to white patients, except among older and surgical subgroups. Medicaid status influenced racial inequalities in mortality, highlighting a need for targeted post-ICU interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102801","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:50:28Z","timestamp":1764057028000},"page":"e102801","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying racial inequalities in long-term outcomes among survivors of critical illness with sepsis in a US cohort: a retrospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4349-5309","authenticated-orcid":false,"given":"Hiam","family":"Naiditch","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor B","family":"Talisa","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"Center for Research, Investigation, and Systems Modeling of Acute Illness (CRISMA), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-3604","authenticated-orcid":false,"given":"Jared W","family":"Magnani","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7465-0581","authenticated-orcid":false,"given":"Seyed Mehdi","family":"Nouraie","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Yende","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"Integrated Veterans Care, Veterans Health Administration, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian B","family":"Mayr","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"Center for 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