Sepsis linked to 1-in-5 deaths worldwide: Lancet study

Sepsis caused about 11 million deaths worldwide in 2017, almost twice as many as previously estimated, according to a study published in The Lancet journal.

The study, led by researchers at the University of Pittsburgh and University of Washington in the US, revealed 48.9 million global cases of sepsis in 2017, and 11 million deaths, representing one in five deaths worldwide.

Sepsis occurs when a person's organs cease to function properly as the result of an out-of-control immune response to infection.

Even if sepsis doesn't kill its victims, it can create lifelong disabilities in survivors, according to the researchers.

The large majority of sepsis cases -- 85 per cent in 2017 -- occurred in low- or middle-income countries, they said.

The highest burden was found in sub-Saharan Africa, the South Pacific islands near Australia, and South, East and Southeast Asia.

Sepsis incidence was higher among females than males, according to the researchers.

By age, the incidence of sepsis peaks in early childhood, with more than 40 per cent of all cases occurring in children under five, they said.

The researchers leveraged the Global Burden of Disease (GBD)Study, a comprehensive epidemiological analysis coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine.

The GBD 2017 Study currently reports on 282 primary causes of death not including sepsis, which is considered an intermediate cause of death.

A primary cause of death is the underlying condition (e.g. cancer), which leads to the intermediate cause (sepsis) that ultimately results in death.

Previous global estimates for sepsis were limited as they relied upon hospital databases from a select group of middle- and high-income countries, the researchers said.

The previous estimates overlooked the substantial burden of sepsis that occurs outside of the hospital, especially in low-income countries, they said.

"We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable," said senior author Mohsen Naghavi, a professor at the University of Washington School of Medicine.

"We need renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition," Naghavi said.

The study analysed annual sepsis incidence and mortality trends from 1990 through 2017, and found rates are improving.

The researchers noted that in 1990, there were an estimated 60.2 million sepsis cases and 15.7 million deaths.

By 2017, incidence had dropped by 19 per cent to 48.9 million cases and deaths by 30 per cent to 11.0 million, they said.

The most common underlying cause of sepsis-related death in both 1990 and 2017 was lower respiratory infection, the researchers said.