Home-to-hospital distance and outcomes among community-acquired sepsis hospitalizations

• Type of Material: Article
• Authors: Joshua F Detelich, Emory University; Nang Thu Kyaw, Georgia State University; Suzanne E Judd, University of Alabama Birmingham; Aleena Bennett, University of Alabama Birmingham; Henry E Wang, Ohio State University; Michael R Kramer, Emory University; Lance A Waller, Emory University; Greg S Martin, Emory University; Jordan A Kempker, Emory University
• Language: English
• Date: 2022-05-30
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2024 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.annepidem.2022.05.001
• Title of Journal or Parent Work: ANNALS OF EPIDEMIOLOGY
• Volume: 72
• Issue: 1
• Start Page: 26
• End Page: 31
• Grant/Funding Information: Dr. Detelich has received funding support from the National Heart, Lung, and Blood Institue (T32HL116271) and the Georgia Clinical and Translational Alliance through the National Center for Advancing Translational Sciences (TL1TR002382 & UL1TR002378), all from the National Institues of Health. Dr. Kempker has received consulting fees from Grifols, Inc. and funding support from the Agency for Healthcare Quality and Research (K08HS025240). For the remaining authors, none were declared.
• Keywords: Regards; Public, Environmental & Occupational Health; Life Sciences & Biomedicine; DEFINITIONS; MANAGEMENT; ORGAN FAILURE; SEPTIC SHOCK; SURVIVAL; Outcomes; THERAPY; Science & Technology; IMPACT; Distance to hospital; GUIDELINES; MORTALITY; Sepsis; ANTIBIOTICS
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health; Biology, Biostatistics

Abstract

Purpose: To examine the hypothesis that longer distance from home-to-hospital is associated with worse outcomes among hospitalizations for community-acquired sepsis. Methods: A secondary analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) prospective cohort of 30,239 white and Black US adults greater than or equal to 45 years old was conducted. Self-reported hospitalizations for serious infection between 2003 and 2012 fulfilling 2/4 systemic inflammatory response syndrome criteria were included. Estimated driving distance was derived from geocoded data and evaluated continuously and as quartiles of very close, close, far, very far (<3.1, 3.1–5.8, 5.9–11.5, and >11.5 miles respectively). The primary outcome was 30-day mortality while the secondary outcome was sequential organ failure assessment (SOFA) score on arrival. Results: Of the 912 hospitalizations for community-acquired sepsis had adequate data for analysis. The median (interquartile range) estimated driving distance was 5.8 miles (3.1,11.7), and 54 (5.9%) experienced the primary outcome. Compared to living very close, participants living very far had a mortality odds ratio of 1.30 (95% CI 0.64,2.62) and presenting SOFA score difference of 0.33 (95% CI -0.03,0.68). Conclusions: Among a national sample of community-acquired sepsis hospitalizations, there was no significant association between home-to-hospital distance and either 30-day mortality or SOFA score on hospital presentation.