S2076 Hospital Type and Regional Disparities in Mortality Among Patients With Spontaneous Bacterial Peritonitis and Sepsis: A National Inpatient Sample Analysis

Introduction: Spontaneous bacterial peritonitis (SBP) complicated by sepsis is a critical condition with high mortality among hospitalized patients with advanced liver disease. Although patient-level factors influence clinical outcomes, further investigation is necessary to understand the impact of hospital characteristics and geographic region on mortality. This study examines the relationship between hospital type, regional location, and in-hospital mortality in patients with SBP and sepsis through a national cohort analysis. Methods: We conducted a retrospective analysis using data from the National Inpatient Sample (NIS) database from 2019 to 2021. Patients hospitalized with a primary diagnosis of SBP were identified, and a subgroup with concurrent sepsis was extracted. Multivariate logistic was used to adjust for confounders. In-hospital mortality was analyzed by hospital location (rural, urban non-teaching, urban teaching) and region (Northeast, Midwest, South, West). STATA software was utilized for statistical analysis. Results: Of 116,160 patients with SBP, 22,559 (19.4%) were diagnosed with concurrent sepsis. Mortality rates varied significantly based on type of hospital type: rural hospitals (43.1%), urban non-teaching hospitals (44.1%), and urban teaching hospitals (50.8%) (P = 0.0025). Regional differences in mortality were also significant: Northeast (55.0%), West (51.4%), South (47.1%), and Midwest (46.9%) (P = 0.0012). Conclusion: This national analysis reveals significant hospital-level and regional disparities in mortality among patients with SBP and sepsis. Patients treated in urban teaching hospitals and those located in the Northeast and Western regions of the United States experienced the highest mortality rates. These findings suggest potential differences in resource allocation, clinical practices, and healthcare access that may contribute to the observed variability. Further investigation into regional care models and systemic barriers is necessary to develop strategies aimed at reducing mortality in these high-risk populations.