A new analysis presented at the Critical Care Reviews annual meeting in Belfast, has found that the number of people dying from sepsis worldwide is twice as high as previously estimated.
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The study, which was also recently described in The Lancet, found that a disproportionately large number of deaths are occurring among children living in poor areas.
The analysis found that in 2017, there were 48.9 million cases of sepsis worldwide and 11 million deaths – representing one in five deaths worldwide.
Sepsis arises when the body’s immune system launches an uncontrolled response to infection and attacks its own organs and tissues, potentially causing life-threatening organ dysfunction and death. Even if sepsis does not cause death, it can leave victims with significant morbidity and life-long disability.
Any contagious pathogen has the potential to cause sepsis, but antimicrobial resistance is a key factor in determining whether a patient responds to treatment and whether sepsis and septic shock develop.
Sepsis may arise as the result of infections acquired in community settings or in healthcare settings. However, healthcare-associated infection is one of the most common adverse events associated with healthcare delivery and accounts for millions of patients affected globally every year. Since the infections have often developed antimicrobial resistance, they can quickly cause debilitating illness.
More details about the study findings
Led by researchers at the University of Pittsburgh and University of Washington School of Medicine, the analysis found that most cases of sepsis – 85% in 2017 – arose in low- or middle-income countries, with the highest burdens reported for sub-Saharan Africa; South, East and Southeast Asia and the South Pacific islands near Australia.
Incidence was higher among females than males and peaked in early childhood, with almost half of cases affecting children under five years of age.
I've worked in rural Uganda, and sepsis is what we saw every single day. Watching a baby die of a disease that could have been prevented with basic public health measures really sticks with you,"
Rudd says she participates in sepsis research because she wants to help solve the tragedy, but asks how researchers are supposed to know whether they are making progress if they do not know the size of the problem: "If you look at any top 10 list of deaths globally, sepsis is not listed because it hasn't been counted.”
What did the current study involve?
The researchers used data collected for the Global Burden of Disease Study, a comprehensive epidemiological analysis conducted by the Institute for Health Metrics and Evaluation in collaboration with the University of Washington School of Medicine.
Currently, the GBD 2017 Study reports on 282 primary causes of death. “Primary causes” does not include sepsis because it considered an intermediate cause of death that ultimately occurs as the result of a primary cause such as cancer.
Previous worldwide sepsis estimates were limited because they used hospital databases from certain middle- and high-income countries and did not account for the substantial number of cases occurring outside of the hospital setting, particularly among low-income countries.
The new findings presented this week are unparalleled because they are the first to account for death rates both within and out of the hospital setting.
"We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable," says senior author Mohsen Naghavi.
What is the solution?
"We need a renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition," warns Naghavi.
Rudd thinks one solution lies in addressing public health infrastructure and ensuring that access to vaccines, clean drinking water, adequate nutrition for children and maternal healthcare are is available to everyone.
However, she points out that sepsis is still a problem in the U.S., where it is the leading cause of death among hospital patients: “Everyone can reduce their odds of developing it by getting the flu shot, and the pneumonia vaccine when appropriate. Beyond that, we need to do a better job preventing hospital-acquired infections and chronic diseases, like diabetes, that makes people more susceptible to infections.”
"Finally, 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 our elected officials for the importance of supporting sepsis prevention and control efforts in low-income communities," concludes Rudd.
Sepsis associated with 1 in 5 deaths globally, double previous estimate. EurekAlert! 2020. Available at:https://www.eurekalert.org/emb_releases/2020-01/uop-saw011320.php
Sepsis. World Health Organization 2018. Available at: https://www.who.int/news-room/fact-sheets/detail/sepsis