Association of gender, age, and race on renal outcomes and mortality in patients with severe sepsis and septic shock

Background: The association of age, gender and race with renal outcomes in patients with severe sepsis and septic shock (SEP) is not completely elucidated. We aimed to shed light on these relationships. Methods: We performed a retrospective cohort study of hospitalized patients in the USA discharged between January 1st, 2005 and December 31st, 2014 using the National Inpatient Sample. We adjusted analyses using the Charlson comorbidity index. Results: 65,772,607 records were included of which 1,064,790 had SEP. There were 60% female and 12% African American (AA). The incidence of SEP was 1.6% and patients with SEP were older, had more AA and less females. Acute kidney injury (AKI) and mortality among patients with SEP were 62% and 30.7% respectively. AA race was associated with increased risk of SEP, AKI and dialysis, (OR = 1.12, 1.25 and 1.7 respectively, all p < 0.001). Female gender was associated with lower risk of all measured outcomes with odds ratios ranging from 0.65 to 0.78 (p < 0.001). Increasing age was associated with a higher risk of all outcomes except for dialysis. Conclusion: Female gender is associated with a lower risk of poor renal outcomes and death among patients with SEP, while AA race places patients at higher risk of poor outcomes in that setting. Increasing age is generally associated with adverse outcomes. (C) 2020 Elsevier Inc. All rights reserved.