A recent study published in The Lancet reveals that global estimates on the prevalence of sepsis incidence and mortality are much higher than previously thought.
A research team led by Dr. Kristina E. Rudd from the University of Pittsburgh has estimated that sepsis likely affects two times more people worldwide than reported in earlier estimates. According to their findings, approximately 48.9 million people suffered from sepsis worldwide in 2017, with 11 million cases resulting in death.
The study incorporated global sepsis incidence and mortality between the years 1990 to 2017. Data was collected from 195 countries and territories, including 282 underlying causes of death, both sexes, and across 23 age groups. In contrast to previous studies, more data from low- and middle-income countries was included in this study. This inclusion accounts for locations where sepsis incidence and mortality were previously under-represented and sepsis incidence and mortality are considerably higher than in more developed countries.
Among the findings, more than half of all global sepsis cases occurred among children, many of which were newborns.
What is sepsis?
Sepsis (sometimes referred to as blood poisoning) always starts with an infection. Sometimes, symptoms of the infection are visible and easily recognizable, for example, when pus forms at the site of a wound. Other times, infections happen inside the body, like when a person contracts pneumonia or a urinary tract infection. When the body’s own defence systems can no longer limit an infection locally, its defence reaction is triggered, which can lead to tissue and organ damage. The symptoms caused by sepsis, including rapid, shallow breathing, low blood pressure and impaired consciousness, are also symptomatic of other illnesses. This, combined with a lack of effective diagnostic methods, contributes to the late detection rate of sepsis in patients, as well as an underestimation of sepsis in clinical documentation.
One of the most frequent causes of death
Every 4 seconds a person dies of sepsis worldwide. Despite its global impact and treatability when detected early, sepsis is often identified too late and treatment is rendered ineffective as the illness has already progressed too far. This can ultimately lead to unnecessary patient death.
Researchers contend that the disease affects far more people than previously thought. In many cases, sepsis must be treated in the intensive care unit. Every year, around 60,000 patients die of sepsis in Germany. Statistically speaking, that is 162 people a day. Sepsis is one of the most frequent causes of death, occurring more frequently than stroke, breast cancer or colon cancer. Despite advances in today’s medicine, especially in the areas of vaccinations, antibiotics and acute care, the number of new cases of sepsis is increasing every year, further burdening already overburdened healthcare systems.
Rapid diagnosis can save lives
The sooner doctors initiate antibiotic treatment, the greater the patient’s chance of survival. Until now, the detection of the pathogens in a microbiological blood culture has been time-intensive, often taking 1-2 days before the correct treatment is prescribed. Detection and treatment within first 60 minutes after the onset of sepsis presents itself as the best treatment window for the highest chance of recovery.
It is alarming that the number of deaths from sepsis is much higher than previously thought, said Mohsen Naghavi of the University of Washington, especially since the disease is both preventable and treatable. Antibiotics and good wound care are among the most effective means of fighting the disease. Vaccinations and the provision of clean drinking water are also considered effective preventive measures against sepsis.
Prevention is key
The global burden of sepsis requires urgent attention, with effective preventive measures playing a key role. Dr. Rand and her team call attention to a number of factors that contribute to the high number of sepsis cases worldwide. Among the measures, the researchers highlight the need for more cost-effective, robust infection prevention measures to be implemented. This is especially crucial in areas with the highest incidence of sepsis, as well as among populations on which sepsis will impart the highest impact, such as newborns and small children.
Many cases of sepsis are suspected as resulting from nosocomial infections. Even patients that are admitted to the hospital for unrelated treatments could be at risk for infection, as a result of invasive devices, such as catheters, or through inadequate hand disinfection among healthcare workers.
Antimicrobial resistance is also an important driver of sepsis. Research and policy interventions on this topic are also regarded as imperative to addressing the disease.
Improving hand hygiene compliance
Achieving sustained improvements in hand hygiene compliance rates among hospital and clinic staff involves a strategic, well-rounded approach. For example, aligning disinfectant dispensers with the workflow of the hospital staff, providing training about the benefits of good hand hygiene, as well as training on the misconceptions about the effect and implementation of correct hand hygiene, can help improve hand hygiene compliance rates. Even small changes, like introducing hi-vis colours on dispenser housing or in the surrounding area can result in increased hand disinfection rates.
Rudd, Kristina E., et al. “Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study.” The Lancet 395.10219 (2020): 200-211.