In January 2020, a groundbreaking study on the global burden of sepsis was published in The Lancet. Cluster member Dr. Tex Kissoon is a co-author on the publication as well as Executive Medical Director of Global Health for Women and Children at BC Children’s Hospital and a Professor at UBC. Here, our patient partner Sue Korstad provides the key takeaways:
Summary
The Global Burden of Disease Study (GBD) is a comprehensive regional and global research program of disease burden that assesses death and disability from major diseases, injuries, and risk factors. GBD is a collaboration of over 3,600 researchers from 145 countries. Sepsis is not part of the standard GBD Injuries and Risk Factors included in this database.
The described study involved a multi-faceted collaboration by health researchers and healthcare providers around the globe. They looked at data from 8.7 million hospital records to calculate in-hospital sepsis associated case-fatality rates from countries worldwide, including Austria, Brazil, Canada, Chile, Georgia, Italy, Mexico, New Zealand, Phillipines & USA. This data was then broken down into location, year, age group, and sex. The paper includes has very detailed breakdown of all the variables, strengths and limitations related to this study, many of which relate to health record and death certificate coding.
This data is essential "to inform and monitor health policy, interventions allocation of resources and clinical treatment initiatives."
Key findings:
Incidence of sepsis: In 1990, there were an estimated 60.2 million cases of sepsis. In 2017 there were an estimated 48.9 million cases. This is a decrease of 18.8 %.
In 217, sepsis incidence is higher among females. Overall sepsis incidence peaks in early childhood, with a 2nd smaller peak among older adults.
Causes of sepsis: The most common underlying cause of sepsis was diarrhoeal disease.
The most common underlying injury leading to sepsis was road traffic injuries. The most common non-communicable (non-contagious) disease leading to sepsis was maternal disorders. In children <5 yrs, diarrhoeal disease, neonatal disorders, and lower respiratory infections were the leading causes of sepsis.
The prevalence of sepsis incidence varied substantially according to location. The highest number of cases were noted in countries with lower socio- economic index (SDI). In 2017, 85% of cases occurred in countries with low, lower-middle and middle SDI.
In 2017, there we 11 million deaths from sepsis worldwide. The most common causes of sepsis-related death were lower respiratory infections, road injuries, maternal and neonatal disorders and diarrhoeal diseases.
Key implications from these findings:
1. Findings produced global sepsis estimates that were more than double previous calculations and overall demonstrated decreasing sepsis burden. However, the disparities between regions are significant and alarming and require urgent attention.
2. There is increasing sepsis incidence in locations least equipped to prevent identify and treat sepsis.
3. More robust and increased infection prevention measures are needed in areas with highest number of cases and deaths. This would have the greatest impacts on neonates.
4. Demonstrates need to implement cost effective measures to improve sepsis outcomes in locations and patient groups with higher sepsis-related mortality.
5. All patients, regardless of underlying source of sepsis, need to have access to basic care services with timely antibiotic administration, and organ support if needed (i.e., for septic shock).
Read the study here:
Rudd KE et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020 Jan 18;395(10219):200-211. DOI: 10.1016/S0140-6736(19)32989-7.