Epidemiology
There are a lack of reliable sepsis incidence and prevalence data. This is due to the absence of a consistent definition for sepsis and differences in coding practice between professionals and organisations.[4][5]
In 2017/18, 186,000 hospital admissions in the UK were for people with a primary diagnosis of sepsis.[6]
Sepsis is present in many hospitalisations that culminate in death. In 2015, 23,135 people in the UK died from sepsis, where sepsis was an underlying or contributory cause of death. NHS England: Sepsis Opens in new window The true contribution of sepsis to these deaths is unknown. Most underlying causes of death in people with sepsis are thought to relate to severe chronic comorbidities and frailty.[5][7][8]
Most epidemiological studies find sepsis to be more common in men than in women. People over 65 years old are particularly susceptible, with one study finding almost two-thirds of people with sepsis to be in this age group.[9]
Risk factors
Associated with an increased risk of sepsis.
Immunocompromise may arise from treatment (e.g., chemotherapy, corticosteroids, or other immunosuppressants), underlying disease (e.g., diabetes, sickle cell), or surgery (e.g., splenectomy).[3][37] Suspect neutropenic sepsis in patients who have become unwell and (a) are having or have had systemic anticancer treatment within the last 30 days or (b) are receiving or have received immunosuppressant treatment for reasons unrelated to cancer.[3]
Risk of sepsis is high in people with indwelling lines or catheters.[3]
Associated with an increased risk of sepsis (relative risk 208.7, 95% CI 142.9 to 296.3).[36]
Decreased resistance to infections, complications of diabetes, and increased surgical complications play a role (relative risk 5.9, 95% CI 4.4 to 7.8).[36]
Risk of sepsis is high in people who misuse drugs intravenously.[3]
Associated with an increased risk of sepsis (relative risk 5.6, 95% CI 3.8 to 8.0).[36]
Pregnancy or recent pregnancy is a risk factor for the development of sepsis.[3] In the UK, the estimated incidence of sepsis in pregnancy has been reported to be 47 cases per 100,000 maternities per year, whereas the estimated annual incidence among people aged 18 to 19 years in a general population has been reported to be around 29.6 cases per 100,000.[9][39]
Risk of sepsis among women may be higher if they have impaired immunity, gestational diabetes, diabetes (or other comorbid condition), needed invasive procedures during pregnancy (e.g., caesarean section, forceps delivery, removal of retained products of conception), had prolonged rupture of membranes during pregnancy, have or have been in close contact with people with group A streptococcal infection (e.g., scarlet fever), or have continued vaginal bleeding or an abnormal vaginal discharge with odour.[3]
Risk of sepsis is high in people with any breach of skin integrity (e.g., cuts, burns, blisters, or skin infection).[3]
May predispose to increased exposure to infections and drug-resistant pathogens (relative risk 2.4, 95% CI 1.2 to 5.6).[36]
Weakly associated with sepsis (relative risk 3.8, 95% CI 2.6 to 5.4).[36]
May be at greater risk (odds ratio 1.28, 95% CI 1.24 to 1.32).[40]
May be at increased risk (odds ratio 1.90, 95% CI 1.80 to 2.00).[40]
Seasonal infections (e.g., respiratory infections in winter) are weakly associated with sepsis.
Sepsis is 1.4 times more likely to occur in the winter than in the autumn.[16]
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