Sepsis – as common as cancer, as deadly as a heart attack

Lisa Mellhammar and Adam Linder. Photo: Åsa Hansdotter/Lund University
A research team at Lund University and Skåne University Hospital has previously shown that about 70,000 adults are affected by sepsis each year in Sweden. In a new study, they demonstrate that more than four percent of all hospital admissions in the south of Sweden (Skåne) are associated with sepsis. It's a significantly underdiagnosed condition that can be likened to an epidemic. The European Sepsis Alliance has assigned the researchers with mapping the prevalence of sepsis in the rest of Europe.

This article was originally published as a pressrelease by Lund University.

In 2016, the research team conducted an initial study in south of Sweden (Skåne) where they revealed that sepsis is much more common than previously believed. The incidence turned out to be 750 adults per 100,000 individuals, which corresponds to 60-70,000 adults affected by sepsis in Sweden each year. In their latest study in the Skåne Region, they showed that more than four percent of all hospitalizations involved that the patient suffered from sepsis and 20 percent of all sepsis patients died within three months. 

– Therefore, sepsis is as common as cancer with similar negative long-term consequences and as deadly as a acute myocardial infarction. Among sepsis survivors, three-quarters also experience long-term complications such as heart attack, kidney problems, and cognitive difficulties, says Adam Linder, sepsis researcher and associate professor at the Department of infection medicine at Lund University, as well as a senior physician at Skåne University Hospital.

Now, the European Sepsis Alliance has assigned the researchers with assessing how common sepsis is in the rest of Europe. Given the differing healthcare systems across countries, it wasn't immediately clear how they should proceed to obtain accurate figures. Consequently, the researchers conducted a pilot study in Skåne to determine if their methods were applicable to other European hospitals.

– Doctors classify patients using diagnostic codes. Since sepsis is a secondary diagnosis resulting from an infection, the condition is significantly underdiagnosed, as the primary disease often dictates the diagnostic code. This makes it challenging to find a way to accurately determine the number of sepsis cases, says Lisa Mellhammar, sepsis researcher at Lund University and assistant senior physician at Skåne University Hospital.

In the study, which is now published in JAMA Network Open, it was revealed that 7,500 patients in the Skåne Region during 2019, were associated with sepsis. During the pandemic, the incidence increased to six percent. However, even without Covid-19, the researchers believe that sepsis should be seen as an epidemic.

The researchers now aim to use the publication to influence the EU to establish a common surveillance system for sepsis. They are in contact with authorities and researchers from around thirty European countries and hope that the research project can secure sufficient funding to start soon. There is no indication that the number of sepsis cases would be lower in other parts of Europe than in Sweden. In Swedish hospitals, only two percent of all sepsis patients are antibiotic-resistant, and the researchers speculate that the proportion of resistant cases is higher in many other European countries.

– Although sepsis care has improved in recent years, we need to enhance our diagnostic methods to identify patients earlier and develop alternative treatment methods beyond antibiotics to avoid resistance. Increasing awareness about sepsis among the public and decision-makers is crucial to ensure that resources are allocated appropriately, concludes Adam Linder.

Publication: Estimating Sepsis Incidence Using Administrative Data and Clinical Medical Record Review | Public Health | JAMA Network Open | JAMA Network

Sepsis facts

  • 90 percent of all sepsis cases are caused by bacteria.
  • To protect the body against the infection, blood vessels create holes in their walls to release white blood cells.
  • In sepsis, these holes don't close, leading to continuous leakage of fluid in the body, which can result in life-threatening organ failure.