Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations
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- 1 February 2016
- journal article
- research article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 193 (3), 259-272
- https://doi.org/10.1164/rccm.201504-0781oc
Abstract
Rationale: Reducing the global burden of sepsis, a recognized global health challenge, requires comprehensive data on the incidence and mortality on a global scale. Objectives: To estimate the worldwide incidence and mortality of sepsis and identify knowledge gaps based on available evidence from observational studies. Methods: We systematically searched 15 international citation databases for population-level estimates of sepsis incidence rates and fatality in adult populations using consensus criteria and published in the last 36 years. Measurements and Main Results: The search yielded 1,553 reports from 1979 to 2015, of which 45 met our criteria. A total of 27 studies from seven high-income countries provided data for metaanalysis. For these countries, the population incidence rate was 288 (95% confidence interval [CI], 215–386; τ = 0.55) for hospital-treated sepsis cases and 148 (95% CI, 98–226; τ = 0.99) for hospital-treated severe sepsis cases per 100,000 person-years. Restricted to the last decade, the incidence rate was 437 (95% CI, 334–571; τ = 0.38) for sepsis and 270 (95% CI, 176–412; τ = 0.60) for severe sepsis cases per 100,000 person-years. Hospital mortality was 17% for sepsis and 26% for severe sepsis during this period. There were no population-level sepsis incidence estimates from lower-income countries, which limits the prediction of global cases and deaths. However, a tentative extrapolation from high-income country data suggests global estimates of 31.5 million sepsis and 19.4 million severe sepsis cases, with potentially 5.3 million deaths annually. Conclusions: Population-level epidemiologic data for sepsis are scarce and nonexistent for low- and middle-income countries. Our analyses underline the urgent need to implement global strategies to measure sepsis morbidity and mortality, particularly in low- and middle-income countries.Keywords
This publication has 61 references indexed in Scilit:
- Severe Sepsis Cohorts Derived From Claims-Based Strategies Appear to be Biased Toward a More Severely Ill Patient Population*Critical Care Medicine, 2013
- Critical care and the global burden of critical illness in adultsThe Lancet, 2010
- Assessment of incidence of severe sepsis in Sweden using different ways of abstracting International Classification of Diseases codes: Difficulties with methods and interpretation of resultsCritical Care Medicine, 2010
- The burden of sepsis-associated mortality in the United States from 1999 to 2005: an analysis of multiple-cause-of-death dataCritical Care, 2009
- Racial Variation in the Incidence, Care, and Outcomes of Severe SepsisAmerican Journal of Respiratory and Critical Care Medicine, 2008
- Seasonal variation in the epidemiology of sepsis*Critical Care Medicine, 2007
- National Study of Emergency Department Visits for Sepsis, 1992 to 2001Annals of Emergency Medicine, 2006
- Immunological processes in malaria pathogenesisNature Reviews Immunology, 2005
- Improved tests for a random effects meta‐regression with a single covariateStatistics in Medicine, 2003
- Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in SepsisSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1992