New data suggest that rates of sepsis-related death around the world are much higher than researchers had expected. “We need renewed focus on sepsis prevention,” specialists advise.
This medical emergency requires immediate intervention to prevent disability and, in the worst-case scenario, death.
Yet in many regions, medical professionals lack the resources to prevent and treat sepsis adequately. This results in extensive fatalities, and until now, researchers have not had data reliable enough to assess the global rates of sepsis-related death accurately.
This has changed thanks to a new analysis conducted by specialists — many from the University of Pittsburgh, in Pennsylvania, and the University of Washington, in Seattle. The results of the investigation now appear in the journal
“I’ve worked in rural Uganda, and sepsis is what we saw every single day,” notes lead study author Dr. Kristina Rudd.
“Watching a baby die of a disease that could have been prevented with basic public health measures really sticks with you. I want to contribute to solving this tragedy, so I participate in research on sepsis,” she adds.
“However, how can we know if we’re making progress if we don’t even 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,” she continues, explaining that this was what motivated the team behind the current analysis.
In their study, the researchers looked at data collected through the Global Burden of Disease Study (GBD).
The most recent GBD data, for 2017, indicate that there are 282 primary causes of death around the world. Sepsis, meanwhile, is classified as an intermediate cause. The underlying conditions that lead to sepsis — such as cancer — are considered primary causes of death.
According to data from 2017, most reported cases of sepsis — as many as 85% — occur in countries with low or middle incomes, with the highest condition burden occurring in sub-Saharan Africa, the South Pacific islands, and regions of South, East, and Southeast Asia.
The GBD 2017 report also found that sepsis incidence was higher among females than males and more common in young children than in people of other ages. According to the authors, more than 40% of sepsis cases occurred in children younger than 5.
In their investigation, Dr. Rudd and colleagues analyzed annual sepsis incidence and mortality trends in countries throughout the globe from 1990 to 2017.
The good news is that they found that rates of death from sepsis are actually declining: In 1990 there were an estimated 60.2 million cases of sepsis and 15.7 million deaths related to the condition — by 2017, the numbers had decreased to 48.9 million cases and 11 million deaths.
However, sepsis is still responsible for around 1 in 5 deaths around the world. And, the researchers add, the current findings contradict
Past estimates, the researchers say, primarily relied on data from middle- and high-income countries and did not take into account the burden of sepsis beyond hospital admissions, particularly among populations in low-income countries.
The current analysis offers, for the first time, a more accurate overview of how sepsis affects people all around the world.
“We are alarmed to find that sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable,” says senior Dr. Mohsen Naghavi.
“We need renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition,” he emphasizes.
The researchers note that according to the available data, the most common cause of sepsis-related death in 1990 and in 2017 was lower respiratory infection.
“So what is the solution?” asks Dr. Rudd. She answers this question herself:
“Well, 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 healthcare would address a lot of these cases.”
She adds that “Sepsis is still a problem here in the [United States], where it is the No. 1 killer of hospital patients.”
Yet people in high-income countries have plenty of ways to minimize their risk of sepsis.
“Everyone can reduce their odds of developing it by getting the flu shot — and the pneumonia vaccine, when appropriate,” explains Dr. Rudd.
“Beyond that,” she explains, “we need to do a better job preventing hospital-acquired infections and chronic diseases, like diabetes, that make people more susceptible to infections.”
Dr. Rudd also notes that more research needs to address ways of lowering sepsis risk in communities most vulnerable to the illness.
“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,” she emphasizes.