Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Incidence and mortality of hospital- and ICU-treated sepsis : results from an updated and expanded systematic review and meta-analysis

Fleischmann-Struzek, C. ; Mellhammar, L. LU ; Rose, N. ; Cassini, A. ; Rudd, K. E. ; Schlattmann, P. ; Allegranzi, B. and Reinhart, K. (2020) In Intensive Care Medicine 46(8). p.1552-1562
Abstract

Purpose: To investigate the global burden of sepsis in hospitalized adults by updating and expanding a systematic review and meta-analysis and to compare findings with recent Institute for Health Metrics and Evaluation (IHME) sepsis estimates. Methods: Thirteen electronic databases were searched for studies on population-level sepsis incidence defined according to clinical criteria (Sepsis-1, -2: severe sepsis criteria, or sepsis-3: sepsis criteria) or relevant ICD-codes. The search of the original systematic review was updated for studies published 05/2015–02/2019 and complemented by a search targeting low- or middle-income-country (LMIC) studies published 01/1979–02/2019. We performed a random-effects meta-analysis with incidence of... (More)

Purpose: To investigate the global burden of sepsis in hospitalized adults by updating and expanding a systematic review and meta-analysis and to compare findings with recent Institute for Health Metrics and Evaluation (IHME) sepsis estimates. Methods: Thirteen electronic databases were searched for studies on population-level sepsis incidence defined according to clinical criteria (Sepsis-1, -2: severe sepsis criteria, or sepsis-3: sepsis criteria) or relevant ICD-codes. The search of the original systematic review was updated for studies published 05/2015–02/2019 and complemented by a search targeting low- or middle-income-country (LMIC) studies published 01/1979–02/2019. We performed a random-effects meta-analysis with incidence of hospital- and ICU-treated sepsis and proportion of deaths among these sepsis cases as outcomes. Results: Of 4746 results, 28 met the inclusion criteria. 21 studies contributed data for the meta-analysis and were pooled with 30 studies from the original meta-analysis. Pooled incidence was 189 [95% CI 133, 267] hospital-treated sepsis cases per 100,000 person-years. An estimated 26.7% [22.9, 30.7] of sepsis patients died. Estimated incidence of ICU-treated sepsis was 58 [42, 81] per 100,000 person-years, of which 41.9% [95% CI 36.2, 47.7] died prior to hospital discharge. There was a considerably higher incidence of hospital-treated sepsis observed after 2008 (+ 46% compared to the overall time frame). Conclusions: Compared to results from the IHME study, we found an approximately 50% lower incidence of hospital-treated sepsis. The majority of studies included were based on administrative data, thus limiting our ability to assess temporal trends and regional differences. The incidence of sepsis remains unknown for the vast majority of LMICs, highlighting the urgent need for improved epidemiological sepsis surveillance.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Burden, Epidemiology, Incidence, Mortality, Sepsis
in
Intensive Care Medicine
volume
46
issue
8
pages
11 pages
publisher
Springer
external identifiers
  • scopus:85086726151
  • pmid:32572531
ISSN
0342-4642
DOI
10.1007/s00134-020-06151-x
language
English
LU publication?
yes
id
114cec39-fc81-41f5-830e-4b0eeb58b9d9
date added to LUP
2020-07-14 07:47:52
date last changed
2024-09-20 01:40:00
@article{114cec39-fc81-41f5-830e-4b0eeb58b9d9,
  abstract     = {{<p>Purpose: To investigate the global burden of sepsis in hospitalized adults by updating and expanding a systematic review and meta-analysis and to compare findings with recent Institute for Health Metrics and Evaluation (IHME) sepsis estimates. Methods: Thirteen electronic databases were searched for studies on population-level sepsis incidence defined according to clinical criteria (Sepsis-1, -2: severe sepsis criteria, or sepsis-3: sepsis criteria) or relevant ICD-codes. The search of the original systematic review was updated for studies published 05/2015–02/2019 and complemented by a search targeting low- or middle-income-country (LMIC) studies published 01/1979–02/2019. We performed a random-effects meta-analysis with incidence of hospital- and ICU-treated sepsis and proportion of deaths among these sepsis cases as outcomes. Results: Of 4746 results, 28 met the inclusion criteria. 21 studies contributed data for the meta-analysis and were pooled with 30 studies from the original meta-analysis. Pooled incidence was 189 [95% CI 133, 267] hospital-treated sepsis cases per 100,000 person-years. An estimated 26.7% [22.9, 30.7] of sepsis patients died. Estimated incidence of ICU-treated sepsis was 58 [42, 81] per 100,000 person-years, of which 41.9% [95% CI 36.2, 47.7] died prior to hospital discharge. There was a considerably higher incidence of hospital-treated sepsis observed after 2008 (+ 46% compared to the overall time frame). Conclusions: Compared to results from the IHME study, we found an approximately 50% lower incidence of hospital-treated sepsis. The majority of studies included were based on administrative data, thus limiting our ability to assess temporal trends and regional differences. The incidence of sepsis remains unknown for the vast majority of LMICs, highlighting the urgent need for improved epidemiological sepsis surveillance.</p>}},
  author       = {{Fleischmann-Struzek, C. and Mellhammar, L. and Rose, N. and Cassini, A. and Rudd, K. E. and Schlattmann, P. and Allegranzi, B. and Reinhart, K.}},
  issn         = {{0342-4642}},
  keywords     = {{Burden; Epidemiology; Incidence; Mortality; Sepsis}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1552--1562}},
  publisher    = {{Springer}},
  series       = {{Intensive Care Medicine}},
  title        = {{Incidence and mortality of hospital- and ICU-treated sepsis : results from an updated and expanded systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1007/s00134-020-06151-x}},
  doi          = {{10.1007/s00134-020-06151-x}},
  volume       = {{46}},
  year         = {{2020}},
}