AUTHOR=Ehrman Robert R. , Malik Adrienne N. , Haber Brian D. , Glassman Seth R. , Bowen Cassidy A. , Korzeniewski Steven J. , Bauer Samantha J. , Sherwin Robert L. TITLE=The role of place-based factors and other social determinants of health on adverse post-sepsis outcomes: a review of the literature JOURNAL=Frontiers in Disaster and Emergency Medicine VOLUME=2 YEAR=2024 URL=https://www.frontiersin.org/journals/disaster-and-emergency-medicine/articles/10.3389/femer.2024.1357806 DOI=10.3389/femer.2024.1357806 ISSN=2813-7302 ABSTRACT=

Sepsis remains a common and costly disease. With early recognition and guideline-based treatment, more patients are surviving to hospital discharge. Many survivors experience adverse health events in the months following discharge, while others suffer long-term physical and cognitive decline. Social, biological, and environmental factors affect all aspects of the disease process, from what pathogens one is exposed to, how/if disease develops, what avenues are available for treatment, as well as short- and long-term sequelae of survival. Disparities in sepsis care exist at all stages of a patient's clinical course, but increased survivorship has highlighted the extent to which Social Determinants of Health (SDoH) influence post-discharge adverse events. Despite increased interest in the last decade, a nuanced understanding of causal relationships remains elusive. This is due to several factors: the narrow range of social determinants of health (SDoH) variables typically studied, the inconsistent and non-standardized methods of documenting and reporting SDoH, and the inadequate acknowledgment of how social, environmental, and biological factors interact. Lack of clear understanding of how SDoH influence post-discharge outcomes is an obstacle to development and testing of strategies to mitigate their harms. This paper reviews the literature pertaining to the effects of SDoH on post-discharge outcomes in sepsis, highlights gaps therein, and identifies areas of greatest need for improving the quality and impact of future investigations.