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National variation in United States sepsis mortality: a descriptive study

Henry E Wang*, Randolph S Devereaux, Donald M Yealy, Monika M Safford and George Howard

  • * Corresponding author: Henry E Wang

  • † Equal contributors

International Journal of Health Geographics 2010, 9:9  doi:10.1186/1476-072X-9-9

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Vitamin D explains some of the findings

William B. Grant   (2011-12-19 11:27)  Sunlight, Nutrition and Health Research Center email

The epidemiology of sepsis in the United States led to an ecological study finding a role for solar UVB and vitamin D. Characteristics included in that study were racial disparities, seasonality, comorbid diseases, and geographical location.

Grant WB. Solar ultraviolet-B irradiance and vitamin D may reduce the risk of septicemia Dermato-Endocrinology. 2009;1(1):37-42.
(the title should have used sepsis).

Vitamin D also reduces the risk of respiratory diseases such as influenza and pneumonia, in part through induction of cathelicidin, in part through shifting cytokine production away from pro-inflammatory ones.

The high rates of sepsis in the southeast corresponds to the region of highest deaths from lung cancer. Respiratory infections comprise the majority of sepsis-attributed deaths, suggesting that smoking and diet may contribute to risk of sepsis.

Competing interests

I receive or have received funding from the UV Foundation (McLean, VA), Bio-Tech-Pharmacal (Fayetteville, AR), and the Vitamin D Council (San Luis Obispo, CA).


Geographic variations in sepsis

Greg Martin   (2010-05-11 14:57)  Emory University

The finding that sepsis mortality varies significantly across the U.S. is important and likely explains part of the healthcare disparities observed with this condition. A previous study using similar methodology reported similar findings regarding geographic variation, but also included analysis of incident cases and linked geographic and seasonal variations in sepsis incidence: see Danai P, et al. Critical Care Medicine 2007; 35: 410–415.

Competing interests



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