Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Jun 21;22(1):564.
doi: 10.1186/s12879-022-07543-8.

Frequency and mortality of sepsis and septic shock in China: a systematic review and meta-analysis

Yan-Cun Liu #  1 , Ying Yao #  2 , Mu-Ming Yu #  2 , Yu-Lei Gao  2 , An-Long Qi  2 , Tian-Yu Jiang  2 , Zhen-Sen Chen  2 , Song-Tao Shou  2 , Yan-Fen Chai  3
Affiliations
Meta-Analysis

Frequency and mortality of sepsis and septic shock in China: a systematic review and meta-analysis

Yan-Cun Liu et al. BMC Infect Dis. .

Abstract

Background: Sepsis, a life-threatening organ dysfunction induced by infection, is a major public health problem. This study aimed to evaluate the frequency and mortality of sepsis, severe sepsis, and septic shock in China.

Methods: We Searched MEDLINE, Embase, PubMed, and Cochrane Library from 1 January 1992 to 1 June 2020 for studies that reported on the frequency and mortality of sepsis, severe sepsis, and septic shock conducted in China. Random effects models were performed to estimate the pooled frequency and mortality of sepsis, severe sepsis, and septic shock.

Results: Our search yielded 846 results, of which 29 studies were included in this review. The pooled frequency of sepsis was estimated at 33.6% (95% CI 25.9% to 41.3%, I2 = 99.2%; p < 0.001), and the pooled mortality of sepsis, severe sepsis and septic shock were 29.0% (95% CI 25.3%-32.8%, I2 = 92.1%; p = 0), 31.1% (95% CI 25.3% to 36.9%, I2 = 85.8%; p < 0.001) and 37.3% (95% CI 28.6%-46.0%, I2 = 93.5%; p < 0.001). There was significant heterogeneity between studies. With a small number of included studies and the changing definition of sepsis, trends in sepsis frequency and mortality were not sufficient for analysis. Epidemiological data on sepsis in the emergency department (ED) are severely lacking, and more research is urgently needed in this area is urgently needed.

Conclusions: Our findings indicated that the frequency and mortality of sepsis and septic shock in China were much higher than North America and Europe countries. Based on our results, an extremely high incidence and mortality of sepsis and septic shock in China's mainland requires more healthcare budget support. Epidemiological data on sepsis and septic shock in ED are severely lacking, and more research is urgently needed in this area. Trial registration This systematic review was conducted according to the statement of the preferred reporting items for systematic review (PROSPERO CRD42021243325) and the meta-analysis protocols (PRISMA-P).

Keywords: China; Frequency; Meta-analysis; Mortality; Sepsis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
HYPERLINK "sps:id::fig1||locator::gr1||MediaObject::0" PRISMA flow chart of studies. PRISMA flowchart describing the process of selecting studies eligible for meta-analysis
Fig. 2
Fig. 2
Random effects meta-analysis of studies reporting mortality of sepsis patients. The forest plots contain exact 95% confidence intervals, and specific studies are weighted using the inverse-variance method
Fig. 3
Fig. 3
Subgroups analysis of sepsis and septic shock mortality. Comparison of pooled mortality rates of sepsis A and septic shock B derived from non-sepsis-3, sepsis-3, 28-30d, in-hospital, 90d, prospective, retrospective, single center, multiple centers, ED, hospital-wide, and ICU studies, showing rates and 95% confidence intervals
Fig. 4
Fig. 4
Random effects meta-analysis of studies reporting mortality of severe sepsis patients. The forest plots contain exact 95% confidence intervals, and specific studies are weighted using the inverse-variance method
Fig. 5
Fig. 5
Random effects meta-analysis of studies reporting mortality of septic shock patients. The forest plots contain exact 95% confidence intervals, and specific studies are weighted using the inverse-variance method
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181–1247. doi: 10.1007/s00134-021-06506-y. - DOI - PMC - PubMed
    1. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211. doi: 10.1016/S0140-6736(19)32989-7. - DOI - PMC - PubMed
    1. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101(6):1644–1655. doi: 10.1378/chest.101.6.1644. - DOI - PubMed
    1. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637. doi: 10.1097/CCM.0b013e31827e83af. - DOI - PubMed
    1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3) JAMA. 2016;315(8):801–810. doi: 10.1001/jama.2016.0287. - DOI - PMC - PubMed