Sepsis Incidence on Rise in U.S.

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Sepsis Incidence on the Rise in U.S.

NEW YORK (Reuters Health) Apr 17 - Sepsis has increased in the US by nearly 9% each year since 1979, according to a new report in the April 17th issue of The New England Journal of Medicine.

Dr. Greg S. and colleagues evaluated national hospital information about patients discharged between 1979 and 2000 in an effort to better understand trends in sepsis in the U.S.

During that time period, they found that rates of sepsis increased 8.7% each year from roughly 164,000 cases in 1979 (about 83 cases per 100,000 people) to nearly 660,000 cases in 2000 (240 cases per 100,000 people).

Fifty-one percent of cases had a specific pathogen listed as a cause of sepsis. More than 90% of those cases were due to bacteria, and nearly 5% of cases were due to fungus.

While the reason for the increased incidence is not clear, Dr. 's group suggests that it might be because doctors are becoming more familiar with the condition and thus are more likely to record it in hospital records.

Other possibilities include an increase in the use of invasive procedures, immunosuppressive drugs, chemotherapy and transplantations. It is also possible that HIV infection and increasing resistance to antibiotics have contributed to the problem, the researchers report.

The good news is that even though more people are developing sepsis, the associated mortality has declined, according to the report. "The total in-hospital mortality rate fell from 27.8% during the period from 1979 through 1984 to 17.9% during the period from 1995 through 2000," the authors note.

Sepsis rates were more common among men than among women and death rates were highest among black men, they add.

"Racial and gender disparities in sepsis incidence are significant, and are cause for additional investigation," said Dr. , who is with Emory University School of Medicine, in Atlanta, in a prepared statement.

"Once we better understand why such differences exist, we can not only work to narrow the gap, but understanding the mechanism for such a difference may improve care for all sepsis patients," he concluded.

Sepsis costs as much as $50,000 per patient and results in an estimated economic burden of nearly $17 billion each year in the U.S., according to the study.

"Accurate national estimates regarding the epidemiology of sepsis are important for the allocation of healthcare resources, for the evaluation of healthcare delivery and for research budgets," Dr. 's group writes.

The study was funded by grants from the National Institutes of Health, the Centers for Disease Control and Prevention and Emory University.

N Engl J Med 2003;348:1546-1554.

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