262: Impact of Social Vulnerability on Short-Term Mortality in Hospital-Onset Sepsis

Introduction: Hospital-onset sepsis (HOS) accounts for 10-15% of all hospital-treated sepsis events, with two-fold higher mortality compared to community-onset sepsis (COS). Social vulnerability is associated with increased mortality in sepsis, but these estimates are driven by COS 47.0% female; 51.7% racial or ethnic minorities; median IQR SVI 0.57 0.33 – 0.80; ICU admission 85.4%; septic shock 84.1%; mechanical ventilation 33.5%). The short-term mortality among HOS hospitalizations was 51.8% in the top SVI quartile vs. 50.5% in the bottom SVI quartile. On adjusted analyses, the top SVI quartile was associated with an increased short-term mortality overall (adjusted odds ratio 1.15 95% CI 1.05-1.24; bottom SVI quartile as reference) and among those aged ≥65 years, females, Whites, ICU admissions, and those with septic shock, or undergoing mechanical ventilation. Conclusions: Higher SVI was associated with increased mortality among patients with HOS. This association was driven by select demographic groups and the more severely ill strata of patients with HOS. Further studies are needed to explore the mechanisms underlying the selective adverse prognostic associations of SVI in HOS.