Sepsis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Synonyms and keywords: sepsis syndrome; septic shock; septicemia

Overview

The hospitalization rate of those with a principal diagnosis of septicemia or sepsis more than doubled from 2000 through 2008. During the same period, the hospitalization rate for those with septicemia or sepsis as a principal or as a secondary diagnosis increased by 70% from 221 to 377 for every 100,000 people. Reasons for these increases may include an aging population with more chronic illnesses, greater use of invasive procedures, immunosuppressive drugs, chemotherapy, transplantation, and increasing microbial resistance to antibiotics.[1]

Epidemiology and Demographics

Incidence and prevalance

  • It is the tenth most common cause of death overall according to data from the Center for Disease Control and Prevention.[2] [1]
  • The hospitalization rate of those with a principal diagnosis of septicemia or sepsis more than doubled from 2000 through 2008, increasing from 116 to 240 per 100,000 population.
  • During the same period, the hospitalization rate for those with septicemia or sepsis as a principal or as a secondary diagnosis increased by 70% from 221 to 377 for every 100,000 people.
  • Reasons for these increases may include an aging population with more chronic illnesses, greater use of invasive procedures, immunosuppressive drugs, chemotherapy, transplantation, and increasing microbial resistance to antibiotics.[3] Increased coding of these conditions due to greater clinical awareness of septicemia or sepsis[4] may also have occurred during the period studied.

Mortality

  • Only 2% of hospitalizations in 2008 were for septicemia or sepsis, yet they made up 17% of in-hospital deaths.
  • In-hospital deaths were more than eight times as likely among patients hospitalized for septicemia or sepsis (17%) compared with other diagnoses (2%). In addition, those hospitalized for septicemia or sepsis were one-half as likely to be discharged home, twice as likely to be transferred to another short-term care facility, and three times as likely to be discharged to long-term care institutions, compared to those with other diagnoses.
  • Sepsis may be the cause for up to 50% of hospital deaths[5][6].

Age

  • For those under age 65, 13% of those hospitalized for septicemia or sepsis died in the hospital, compared with 1% of those hospitalized for other conditions.[1]
  • For those aged 65 and over, 20% of septicemia or sepsis hospitalizations ended in death compared with 3% for other hospitalizations.
  • Sepsis is common and also more dangerous in elderly, immunocompromised, and critically ill patients.

Race

  • More common in African Americans compared to other races in the United States.

Developed Countries

  • In the United States, sepsis is the leading cause of death in non-coronary ICU patients.

Worldwide

  • It is a major cause of death in intensive care units worldwide, with mortality rates that range from 20% for sepsis to 40% for severe sepsis to > 60% for septic shock.
  • It occurs in 1%-2% of all hospitalizations and accounts for as much as 25% of intensive care unit (ICU) bed utilization.

References

  1. 1.0 1.1 1.2 "Products - Data Briefs - Number 62 - June 2011". Retrieved 2012-09-17.
  2. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003 Apr 17;348(16):1546-54. PMID 12700374 Full Text.
  3. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. "Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care". Critical Care Medicine. 29 (7): 1303–10. PMID 11445675.
  4. Wiedermann CJ, Adamson IY, Pert CB, Bowden DH. "Enhanced secretion of immunoreactive bombesin by alveolar macrophages exposed to silica". Journal of Leukocyte Biology. 43 (2): 99–103. PMID 2826633.
  5. Rhee C, Jones TM, Hamad Y, Pande A, Varon J, O'Brien C; et al. (2019). "Prevalence, Underlying Causes, and Preventability of Sepsis-Associated Mortality in US Acute Care Hospitals". JAMA Netw Open. 2 (2): e187571. doi:10.1001/jamanetworkopen.2018.7571. PMC 6484603. PMID 30768188.
  6. Liu V, Escobar GJ, Greene JD, Soule J, Whippy A, Angus DC; et al. (2014). "Hospital deaths in patients with sepsis from 2 independent cohorts". JAMA. 312 (1): 90–2. doi:10.1001/jama.2014.5804. PMID 24838355.

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