Global sepsis deaths twice as high as previously thought, University of Pittsburgh study finds

Sepsis is a bigger global threat than previously believed, according to a new study published in the Lancet. 

The potentially life-threatening condition was responsible for one in every five deaths worldwide, nearly double previous estimates, researchers said.

The study used data from the Global Burden of Disease Study as the foundation for the most comprehensive view of sepsis cases worldwide. Previous studies relied on limited data from adults in high-income countries or national estimates based on hospital databases with inconsistent diagnosis definitions.

According to the authors, most studies have also excluded children who disproportionately bear the global burden of the condition. Among the 48.9 million cases reported worldwide in 2017, the new study found that more than half occurred in infants and children. Regions with the highest incidence of sepsis included sub-Saharan Africa, Oceania, South Asia, East Asia, and Southeast Asia. In total, sepsis caused 11 million deaths globally in 2017.

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The benchmark data provided by the study should prove vital for focusing the attention of providers and policymakers on sepsis, according to the study’s lead author, Kristina Rudd, M.D., M.P.H., assistant professor of Critical Care Medicine at the University of Pittsburgh.

“There has been a conversation in the last two years among sepsis and critical care communities, mostly initiated by researchers and clinicians in high-income areas, saying that sepsis is maybe being made to be a bigger deal than it actually is,” she said in a video interview about the study. “I think that our findings really give numbers to the concerns that our colleagues in lower- and middle-income countries have been raising for years.”

The increased estimates of both sepsis cases and deaths noted in the study likely most likely is attributable to more accurate data from low-income and middle-income countries, which experience a disproportionate number of cases worldwide. High-income countries still have significant work to do to address the condition, as well, however. Rudd points out that sepsis is the number one cause of death for hospital patients in the United States.

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For areas with the highest incidence of sepsis, the study’s authors propose the assessment and introduction of more robust systems to control infection. “To start with, it’s basic public health infrastructure. Vaccines, making sure everyone has access to a toilet and clean drinking water, adequate nutrition for children and maternal health care would address a lot of these cases,” Rudd said. 

The study’s authors also emphasize the importance of further research to support policy interventions targeting sepsis. They recommend areas of focus such as appropriate and timely administration of antibiotics, efforts targeting microbial resistance, greater availability of appropriate acute-care facilities, and increased capacity to support patients experiencing organ dysfunction.

“For people in high-income countries who want to help reduce the rates of sepsis in low-income areas, we need to support research into treatments and advocate to our elected officials for the importance of supporting sepsis prevention and control efforts in low-income communities,” Rudd said.