Sepsis Mortality in the U.S. Correctional System: An Underappreciated Disparity

The effect of incarceration on sepsis outcomes in the United States is infrequently described in the literature. This study sought to investigate whether being incarcerated affected mortality rates in sepsis. The retrospective study used data from October 1, 2013, to November 30, 2016, of patients admitted with a diagnosis of sepsis at a tertiary care center with a primary outcome of in-hospital mortality. The study cohort included 8,568 cases of sepsis, of which 8,448 were noninmates and 120 were inmates. Overall mortality was 15.7%; for noninmates, the rate was 15.3%, and for inmates, 42.5%. The risk of death among inmates was 2.8 times that of noninmates. Neither age, sex, nor race were significant confounders. Findings suggest a direct association between incarceration and sepsis mortality. Larger regional or nationwide case-control studies should be conducted to confirm these findings.