Though preventable and treatable, sepsis — a life threatening complication of an infection— claimed about 11 million lives worldwide in 2017, almost twice as high as previously estimated.
According to a study published in the latest edition of The Lancet, among the victims are a disproportionately high number of children in poor areas. Sepsis is caused by the body’s defense system (immune system) working overtime to fight infection. The large number of chemicals released into the blood during this process triggers widespread inflammation.
Blood clotting during sepsis reduces blood flow to limbs and internal organs.
This deprives them of nutrients and oxygen. In severe cases, one or more organs
may fail.
India too is facing tremendous sepsis burden. At least, 34 per cent of sepsis patients died in the intensive care unit (ICU) in 2016, as per another study.
The Lancet study, which is led by researchers at the University of Pittsburgh and University of Washington schools of medicine, revealed 48.9 million global cases of sepsis in 2017 and 11 million deaths, representing 1 in 5 deaths worldwide.
The large majority of sepsis cases - 85 per cent in 2017 - occurred in low- or middle-income countries, higher among females than males. By age, the incidence of sepsis peaks in early childhood, with more than 40 per cent of all cases occurring in children under 5.
“I’ve worked in rural Uganda, and sepsis is what we saw every single day. Watching a baby die of a disease that could have been prevented with basic public health measures really sticks with you,” said lead author Kristina E Rudd, assistant professor in Pitt’s Department of Critical Care Medicine.
For their analysis, Rudd and colleagues leveraged the Global Burden of Disease Study, a comprehensive epidemiological analysis coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine.
The study findings are unprecedented as they represent mortality both in and out of the hospital.
“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, professor of health metrics sciences at IHME 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.”
The study authors analyzed annual sepsis incidence and mortality trends from 1990 through 2017 and found rates are improving.
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.
“So what is the solution? Well, to start with its basic public health infrastructure. Vaccines, making sure everyone has access to a toilet and clean drinking water, adequate nutrition for children and maternal health care would address a lot of these cases,” said Rudd.
The research was funded by The Bill & Melinda Gates Foundation, the National Institutes of Health Pitt, the British Columbia Children’s Hospital Foundation, the Wellcome Trust and the Fleming Fund.