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. 2022 Oct 10;4(10):e0775.
doi: 10.1097/CCE.0000000000000775. eCollection 2022 Oct.

Sepsis-Related Mortality Rates and Trends Based on Site of Infection

Jonathan Prest  1 , Thai Nguyen  1 , Tiffany Rajah  2 , Alayna B Prest  3 , Matheni Sathananthan  1 , Niranjan Jeganathan  4
Affiliations

Sepsis-Related Mortality Rates and Trends Based on Site of Infection

Jonathan Prest et al. Crit Care Explor. .

Abstract

Sepsis is defined as life-threatening organ dysfunction triggered by an underlying infection. A recent study noted that the overall sepsis-related mortality rate in the United States is stable. In this study, we evaluated the sepsis-related mortality rates and trends associated with the three most common sites of infection.

Design: Retrospective population-based study.

Setting: Multiple Cause of Death (MCOD) database available through the Centers for Disease Control and Prevention website.

Patients: Decedents with sepsis-related deaths and the source of sepsis were identified using previously validated International Classification of Diseases codes.

Interventions: None.

Measurements and main results: From 2004 to 2018, using the MCOD, the age-adjusted mortality rate per 1,000,000 population from pulmonary sepsis was 111.8, from abdominal sepsis was 46.7, and from genitourinary sepsis was 52. Mortality rates from all three sites increased. Males had a higher mortality rate from pulmonary sepsis and abdominal sepsis and lower mortality rate from genitourinary sepsis. Black and Native American decedents had the highest mortality rates from all three sepsis sites. Compared with White decedents, Hispanic decedents had a higher mortality rate from pulmonary sepsis but lower rate from genitourinary sepsis. Asian decedents had the lowest mortality rates from abdominal and genitourinary sepsis but similar mortality rates from pulmonary sepsis as White decedents. The mortality rate increased in White and Native American decedents for all three sepsis sites, whereas in Hispanic decedents only abdominal and genitourinary sites increased, and in Black and Asian decedents only abdominal sepsis rates increased.

Conclusions: Despite the overall stable sepsis-related mortality rates, the rates secondary to pulmonary, abdominal, and genitourinary sepsis are increasing in both sexes and all age groups. This is likely due to improved identification/documentation of a site of infection in patients with sepsis. We noted significant racial variation in mortality rates/trends, which should be considered in future studies.

Keywords: infection; mortality; sepsis; site; source.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart showing the study cohort. CDC = Centers for Disease Control and Prevention.
Figure 2.
Figure 2.
Age-adjusted mortality rates from (A) pneumonia and pulmonary sepsis, (B) intra-abdominal infections and abdominal sepsis, (C) genitourinary infections and genitourinary sepsis, in the United States, 2004–2018.
Figure 3.
Figure 3.
Underlying cause of death in decedents with sepsis in the United States by the anatomic site of infection. Source of infection refers to pneumonia for pulmonary sepsis, intra-abdominal infections for abdominal sepsis, and genitourinary infections for genitourinary sepsis.
Figure 4.
Figure 4.
Place of death of decedents with sepsis in the United States by the anatomic site of infection.
See this image and copyright information in PMC

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