Use of Electronic Health Record Data to Evaluate the Impact of Race on 30-Day Mortality in Patients Admitted to the Intensive Care Unit

J Racial Ethn Health Disparities. 2017 Aug;4(4):539-548. doi: 10.1007/s40615-016-0256-6. Epub 2016 Jun 20.

Abstract

Introduction: The current body of literature examining the impact of race upon outcomes for patients admitted to the intensive care unit (ICU) is limited. The primary objective of our study was to explore this question using a large cohort drawn from an electronic health record (EHR)-based data source.

Methods: We conducted a retrospective cohort study using Multiparameter Intelligent Monitoring in Intensive Care (MIMIC-II), an EHR-derived database encompassing ICU admissions to an academic medical center in Boston, Massachusetts, between 2001 and 2008. Adults admitted to a medical or surgical ICU were assessed for the primary outcome of 30-day mortality and secondary outcomes of in-hospital mortality and hospital length-of-stay. Multivariate logistic regression was used to determine the association between race and the primary outcome.

Results: The study cohort consisted of 14,684 adult ICU patients-10,562 White, 1311 Black, 363 Asian, 868 "Other," and 1580 without known race. Thirty-day mortality rates experienced by Black and Asian individuals were significantly lower than mortality among those identified as White, with odds ratios of 0.62 (95 % CI 0.50-0.77) and 0.64 (95 % CI 0.44-0.93), respectively. Patients without known race experienced the highest crude mortality overall (27.4 %) and twice the adjusted odds of mortality compared with the White group.

Conclusions: In a large, racially diverse cohort of general ICU patients, White patients experienced significantly higher mortality than non-White patients. Our results are consistent with findings from other studies that indicate that the non-White race does not appear to negatively impact short-term survival following ICU admission.

Keywords: Critical care; Disparities; Electronic health records; Intensive care unit; Outcomes; Race.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Academic Medical Centers
  • Adult
  • African Americans / statistics & numerical data
  • Aged
  • Aged, 80 and over
  • Asian Americans / statistics & numerical data
  • Boston / epidemiology
  • Continental Population Groups / statistics & numerical data*
  • Electronic Health Records
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Hospital Mortality / ethnology*
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Retrospective Studies