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To the Editor

Published:September 21, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.09.003
      We appreciate the comments that were raised by Panakala et al. regarding our study titled “Lower socioeconomic factors are associated with higher mortality in patients with septic shock”. In this study, we attempted to investigate the effect of race/ethnicity, economic status, neighborhood, and access to health care in patients with septic shock. Panakala et al. noticed that the included patients only had SOFA scores reported rather than the “type and statistics of dysfunctional organ systems”. We chose to report SOFA scores as they are a commonly used metric in both research and clinical practice that encompasses varying degrees of organ dysfunction. Secondly, Panakala et al. state that there is a concern for inflation of exclusion criteria. We agree that the study has a high exclusion rate as approximately 64% of reviewed patients were excluded. That being said, most of the excluded patients were because they had been outside hospital transfers which could have biased our study if included. The second most common exclusion reason was patients not meeting septic shock criteria per the guidelines which were imperative given the nature of the question that the study was trying to answer. Panakala et al. also point out that the study was only from patients that were seen at two hospitals which we agree is a limitation and we stated so in the conclusions. Lastly, Panakala et al. comment on educational attainment. We firmly agree that this variable likely plays an important role in hospital mortality and we initially attempted to collect it but, unfortunately, the data set from which the study was conducted did not include this variable.
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