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
. 2025 Dec;53(6):2601-2612.
doi: 10.1007/s15010-025-02601-0. Epub 2025 Jul 15.

Rising rates of sepsis in England: an ecological study

Victoria B Allen  1 , Katie Bechman  2 , Mark D Russell  2 , Maryam A Adas  2 , Anna L Goodman  3   4   5 , Mark J McPhail  6 , Sam Norton  2 , James B Galloway  2
Affiliations

Rising rates of sepsis in England: an ecological study

Victoria B Allen et al. Infection. 2025 Dec.

Abstract

Purpose: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. It is a major cause of morbidity and mortality. A contemporary overview of sepsis epidemiology in England is long overdue. This study provides an update on the incidence of sepsis-coded hospital admissions and mortality following the COVID-19 pandemic, focusing on the relative contribution of different bacterial pathogens to sepsis-coded admissions.

Methods: We undertook a descriptive study of all hospital admissions from April 1998 to March 2024 using routinely collected health data. Information on sepsis admission episodes, causative pathogens, age, sex, length-of-stay and mortality were collected.

Results: Sepsis-coded hospital admissions increased from 27.9 admissions per 100,000 in 1998 to 210.4 in 2023, a 7.5-fold increase. The incidence of sepsis-coded admissions due to most pre-specified pathogens of interest increased. The largest increases were seen for sepsis due to Enterococci, Streptococcus pyogenes, gram-negative bacteria, Streptococcus agalactiae, Staphylococcus aureus and Listeria spp. Sepsis due to meningococcus decreased. The percentage of patients aged ≥ 75 years admitted with sepsis increased from 32.4 to 52.5% of sepsis cases. Median length-of-stay was 6.1 days. Sepsis-coded admissions and mortality decreased during the COVID-19 pandemic. These have now returned to pre-pandemic levels.

Conclusion: The recorded incidence of sepsis-coded hospital admissions has risen. This may have been impacted by coding changes and improved disease recognition. The decrease in meningococcal sepsis may reflect the success of vaccination campaigns. Further research is needed to explore concurrent trends in sepsis severity, predict who is at greatest risk and improve prevention efforts.

Keywords: Incidence; Length of stay; Public health; Routinely collected health data; Sepsis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: VBA, MAA, AG, MJM and SN have no known competing financial interests. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JBG has received honoraria from Abbvie, Amgen, Celgene, Chugai, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Sobi, and UCB, and has research funding from Amgen, Aztra-Zeneca, Gilead, Janssen, Medicago, Novovax and Pfizer. MDR has received honoraria from AbbVie, Biogen, Lilly, Galapagos, Menarini, UCB, and Viforpharma. KB has received grant funding from the Pfizer/Versus Arthritis; honoraria from Galapagos, UCB, and Viforpharma; and educational support from UCB.

Figures

Fig. 1a
Fig. 1a
Trends in sepsis-coded hospital admissions in England (all ICD-10 codes) by year. Admissions are reported per 100,000 population of England using ONS mid-year population estimates. The dashed red line corresponds to the introduction of sepsis coding changes in England in 2017. The dashed blue line corresponds to the COVID-19 pandemic in England
Fig. 1b
Fig. 1b
Joinpoint analysis was used to identify points where trends changed significantly. Breakpoints were detected in 2010/11 and 2014/15 indicating shifts in the rate of incidence change
Fig. 2
Fig. 2
Trends in sepsis-coded hospital admissions caused by particular pathogens of interest by year. Admissions are reported per 100,000 population of England using ONS mid-year population estimates and are shown on a logarithmic scale for clarity. The dashed red line corresponds to the introduction of sepsis coding changes in England in 2017. The dashed blue line corresponds to the COVID-19 pandemic in England
Fig. 3
Fig. 3
Death registrations in England and Wales with sepsis as the main cause of death or mentioned anywhere on the death certificate. Deaths are reported per 100,000 population of England and Wales using ONS mid-year population estimates. The dashed red line corresponds to the introduction of sepsis coding changes in England in 2017. The dashed blue line corresponds to the COVID-19 pandemic in England
Fig. 4
Fig. 4
Proportion of patients coded as admitted with sepsis aged 0–14 years, 15–59 years, 60–74 years and ≥ 75 years
See this image and copyright information in PMC

References

    1. Singer M, et al. The third international consensus definitions for Sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10. - DOI - PMC - PubMed
    1. Rudd KE, et al. Global, regional, and National sepsis incidence and mortality, 1990–2017: analysis for the global burden of disease study. Lancet. 2020;395(10219):200–11. - DOI - PMC - PubMed
    1. The UKS. Trust, References & Sources 14th October 2024]; Available from: https://sepsistrust.org/about-sepsis/references-sources/
    1. Burki TK. Sharp rise in sepsis deaths in the UK. Lancet Respir Med. 2018;6(11):826. - DOI - PubMed
    1. Shankar-Hari M, et al. Epidemiology of sepsis and septic shock in critical care units: comparison between sepsis-2 and sepsis-3 populations using a National critical care database. Br J Anaesth. 2017;119(4):626–36. - DOI - PubMed

LinkOut - more resources