Research trends and topics on sepsis immunosuppression: a bibliometric and visual analysis of global research from 2004 to 2024

Abstract

Background: Sepsis, a condition characterized by critical organ impairment resulting from dysregulated response to infection, remains a leading cause of mortality globally. Immunosuppression significantly dictates the clinical trajectory and ultimate prognosis in sepsis. Research on sepsis-related immunosuppression has gained substantial attention in recent years. However, a comprehensive and objective analysis of the current state of research remains scarce. This study employs bibliometric techniques and knowledge mapping to provide a visual analysis of trends and developments in sepsis immunosuppression, offering a systematic overview for researchers in the field.

Objectives: This study aims to: (1) Quantitatively characterize global publication trends, key contributors (countries/institutions/journals/authors), and collaborative networks in sepsis immunosuppression research (2004-2024); (2) Identify current hotspots and future directions in this field.

Materials and methods: Articles and reviews related to sepsis immunosuppression were sourced from the Web of Science Core Collection via subject-specific searches. Bibliometric analyses were executed using Excel 365, CiteSpace, VOSviewer, and Bibliometrix (R-Studio's R-Tool).

Results: From January 1, 2004, to March 22, 2024, 3,082 articles on sepsis immunosuppression authored by 16,545 individuals across 116 institutions from 30 countries were identified. Collaborative network analysis highlights the United States as the leading contributor, with key institutions including the University of Florida and Washington University. Strong international collaboration is evident, particularly between the United States and China, as well as the United States and Germany. Frontiers in Immunology emerged as the most prolific journal, while Journal of Immunology garnered the highest co-citation frequency. Guillaume Monneret has published the greatest number of relevant articles, while Richard S. Hotchkiss is the most frequently co-cited author. The research predominantly focuses on immunology, molecular biology, and clinical treatments. Keyword analysis suggests that immune cells, cell death, and personalized clinical treatments are emerging research hotspots in the field.

Conclusion: This bibliometric analysis maps evolving trends and forecasts emerging hotspots in sepsis immunosuppression research, providing direction for future studies.

Keywords: bibliometric analysis; clinical treatment; immunoparalysis; immunosuppression; sepsis.

Figure 1

The flowchart of screening process.

Figure 2

The annual number of publication volume and citation frequency in sepsis immunosuppression from 2004 to 2024.

Figure 3

Visualizing cooperation between countries/regions. (A) The network map of cooperation between countries. Lines between nodes represent cooperation, and the color of the lines indicates the first cooperation year. The thickness between the connecting lines represents the closeness of the ties. (B) Country collaboration map. The links between countries represent their collaborations.

Figure 4

Analysis of institutions related to sepsis-induced immunosuppression. (A) Clustering of institutions based on similarity of research topics. (B) Collaborative network visualization of institutions.

Figure 5

Multidimensional visualization of journals related to sepsis-induced immunosuppression. (A) Core-periphery distribution pattern delineated by Bradford’s Law analysis. (B) The dual-map overlay of journals, with citing journals (left) and cited journals (right) are connected through colored citation trajectories. (C) Visualization of co-journals in VOSviewer.

Figure 6

Analysis of authors associated with sepsis-induced immunosuppression. (A) Author co-occurrence graph. Nodes of different colors reflect authors in different clusters. Node size indicates co-occurrence frequency and links indicate co-occurrence relationships between authors. (B) Density visualization of sepsis-related author links. Stronger correlations are usually presented as dark areas or clusters, while weaker correlations may appear as scattered dots or lighter-colored areas.

Figure 7

Visualization of authors. (A) The graph shows authors active in research on sepsis immunosuppression. The color represents the year of their activity, with yellow indicating the most recent years. (B) Visualization of authors’ publications and citations over time. (C) The co-authorship network, the node size represents the publications and citation frequencies, and the linkages mean collaborations.

Figure 8

Analysis of references related to sepsis immunosuppression. (A) Clustering of references based on the similarity between references. (B) The 25 most highly cited documents. The red bar represents the high citation rate for the corresponding year.

Figure 9

Analysis of keywords related to sepsis immunosuppression. (A) The co-occurrence network diagram. The varied colored nodes reflect the keywords in various clusters. The node size means the occurrence frequencies, and the lines mean the co-occurrence relationships between keywords. (B) Average normalized citation count. Blue represents the keyword’s smaller average normalized citation count, and red represents the larger average normalized citation count. If two keywords appear in the same line of a corpus file at the same time, it means that the author may have discussed both keywords in the same text, or both keywords appear in the same topic or context. A smaller distance between two keywords usually indicates that the two keywords are more related to each other and may occur in the same sentence, the same paragraph, or in adjacent sentences or paragraphs.

Figure 10

Visualizing hotspot changes. (A) The top 25 keywords with the strongest citation bursts. (B) Thematic map of research on sepsis immunosuppression. The horizontal axis denotes relevance, while the vertical axis represents developmental intensity. (C) Conceptual structure map. (D) Trend topics visualization.

Figure 11

Analysis of hotspot shifts. (A) Annual heatmap depicting keyword popularity (2004–2024) in sepsis immunosuppression research, normalized by the annual citation proportion. (B) Keyword correlation heatmap. Keywords exhibiting high popularity within similar time periods are clustered together and color coded.