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Archived Comments for: National variation in United States sepsis mortality: a descriptive study

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  1. Geographic variations in sepsis

    Greg Martin, Emory University

    11 May 2010

    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


  2. Vitamin D explains some of the findings

    William B. Grant, Sunlight, Nutrition and Health Research Center

    19 December 2011

    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).