Double Take

The severity of sepsis is notorious. What isn’t so clear is our grasp on global statistics, which inform health policy interventions, resource allocation, and clinical treatment initiatives (1). The newly published Global Burden of Sepsis study – the most comprehensive to date on the incidence and mortality of sepsis – has revealed that true global rates are over double those previously estimated. New figures put the number of cases at 48.9 million and deaths at 11 million around the world in 2017 – a far cry from the previous global estimates of 19.4 million cases and 5.3 million deaths.

But how could previous figures fall so short? We put the question to Konrad Reinhart and Niranjan Kissoon, co-authors of the new study and President and Vice President of the Global Sepsis Alliance, respectively. “We weren’t surprised, because we knew that previous estimates were exclusively derived from high-income countries, where the number of deaths from infectious diseases is considerably lower than in low- and middle-income countries.” In fact, the previous data came from hospitalized adults in just seven high-income countries, whereas the new study analyzed 109 million death records across 195 countries between 1990 and 2017.

In 2017, an estimated 85 percent of global sepsis cases occurred in these low- and middle-income countries – and half were in children. “National action plans must include prevention strategies, such as large-scale vaccination programs – especially for children and adults in high-risk groups – against preventable infections like pneumonia, measles, common flu, and meningitis,” say Reinhart and Kissoon. The WHO designated sepsis an urgent global priority in May 2017, resolving to improve the prevention, diagnosis, and management of the deadly condition in developing countries.

However, with sepsis responsible for one in five deaths worldwide, Reinhart and Kissoon see a long road ahead: “Poor awareness among policymakers and a lack of adequate national strategies are worrying, as is the lack of education for healthcare workers and the public in terms of recognizing and treating sepsis early.”