Is the Mortality Rate from Sepsis Improving?

SUMMARY

  • The true incidence of sepsis is difficult to define.
  • Sepsis cases are not evenly distributed
  • Despite global efforts on improved recognition and management, the overall sepsis mortality rate has been stable.
  • Sub-segments of the population may be experiencing increasing mortality rates.

BACKGROUND

  • Sepsis is a major global health priority
  • Previous reports indicate the incidence of sepsis by country. However, this assumes a uniform distribution across an entire country/region.
  • The recent attention focusing on sepsis via guidelines, management recommendations and educational efforts may also have an influence on overall incidence.
  • Although the incidence may be increasing due to increased awareness, Rhee et al report overall mortality has been decreasing.

REVIEW

Prest etl al Critical Care Medicine 2021;49:1276-1284

  • 2005 – 2018 United States Deaths = 36,067,309
  • 2,427,907 deaths with diagnosis of sepsis (6.7% of all deaths)
  • Overall  There was no difference in sepsis mortality rates

Mortality rates varied by geographic region.

 
  • However, the following groups had a statistically significant greater mortality risk when compared to the reference groups.
    • Men (1.26 relative risk)
    • Ages 75-84 years (2.36 relative risk)
    • Over age 85 years (5.47 relative risk
  • When evaluated by race and gender:
    • Whites and Native Americans had increased mortality rates in both genders
    • African Americans, Hispanic and Asian patients had decreases in mortality
  • 81.1% of deaths occurred in the inpatient setting

CONCLUSIONS

  • Overall sepsis mortality rates appear to be stable over a 13 year period in the United States
  • One uniform rate per country/region does not apply.
  • Rather multiple reasons for disparities are present. Including:
    • Gender
    • Race
    • Socioeconomic group
    • Education level
    • Health insurance level

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Erkan Hassan is the Co-Founder & Chief Clinical Officer of Sepsis Program Optimization where he designs & oversees the implementation of solutions to optimize sepsis programs.

To discuss your organization’s Barriers of Effective Sepsis Care, contact Erkan by phone (844) 4SEPSIS (844-473-7747), email (erkan@spo.icu), or video chat.