In US, Life-Threatening Sepsis on the Rise
NEW YORK (Reuters Health) - The life-threatening condition known as sepsis has increased nearly nine percent each year in the U.S. since 1979, according to a new analysis of hospital records.
Sepsis is a dangerous immune reaction to infection or injury that can cause blood pressure to plummet and organs to fail. The condition typically kills 20 percent to 50 percent of patients who have a severe case.
In the new study, Dr. Greg S. Martin 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 percent 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).
It's not clear why the researchers saw an increase in cases. It might be because doctors are becoming more familiar with the condition and thus are more likely to record it in hospital records, according to the report.
Other possibilities include the increase in the use of invasive procedures, immune-system suppressing drugs, chemotherapy and transplants. It's also possible that HIV (news - web sites) infections and increasing resistance to antibiotics contributed to the problem, the researchers said.
The good news is that even though more people were developing sepsis, the mortality rate associated with the disease declined, according to the report in Thursday's issue of The New England Journal of Medicine (news - web sites).
"The total in-hospital mortality rate fell from 27.8 percent during the period from 1979 through 1984 to 17.9 percent during the period from 1995 through 2000," the authors write.
Sepsis rates were more common among men than 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 Martin, who is with Emory University School of Medicine, in Atlanta, Georgia, 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.
Care of people with 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 health care resources, for the evaluation of health care delivery and for research budgets," writes Martin and colleagues.
Bacterial infection can trigger sepsis, as can serious injury. While people with weakened immune systems are susceptible to sepsis, experts say, even a young person in a motor vehicle accident can develop sepsis.
In the study, 51 percent of cases had a specific germ listed as a cause of sepsis. More than 90 percent of those cases were due to bacteria, and nearly five percent of cases were due to a fungus.
The study was funded by grants from the National Institutes of Health (news - web sites), the Centers for Disease Control and Prevention (news - web sites) and Emory University.
SOURCE: The New England Journal of Medicine 2003;348:1546-1554. |
