Assessment of Global Incidence and Mortality of Hospital-treated Sepsis - Current Estimates and Limitations.
Am J Respir Crit Care Med. 2015 Sep 28;
Authors: Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, Angus DC, Reinhart K, International Forum of Acute Care Trialists
Abstract
RATIONALE: Reducing the global burden of sepsis, a recognised global health challenge, requires comprehensive data on the incidence and mortality on a global scale.
OBJECTIVE: To estimate the worldwide incidence and mortality of sepsis and to 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.
MAIN RESULTS: The search yielded 1553 reports from 1979 to 2015, of which 45 met our criteria. 27 studies from 7 high-income-countries provided data for meta-analysis. For these countries, the population incidence rate was 288 [95%CI, 215-386, τ=0.55] hospital-treated sepsis cases and 148 [95%CI, 98-226, τ=0.99] 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] sepsis and 270 [95%CI, 176-412, τ=0.60] 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 epidemiological data for sepsis are scarce, and non-existent 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.
PMID: 26414292 [PubMed - as supplied by publisher]