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Global, Regional, and National Sepsis Incidence and Mortality, 1990–2021: A Systematic Analysis Publisher Pubmed



Gray AP ; Chung E ; Hsu RL ; Araki DT ; Gershberg Hayoon A ; Davis Weaver N ; Swetschinski LR ; Wool EE ; Han C ; Mestrovic T ; Ikuta KS ; Abbas N ; Abbasi M ; Abd Elhafeez S Show All Authors
Authors
  1. Gray AP
  2. Chung E
  3. Hsu RL
  4. Araki DT
  5. Gershberg Hayoon A
  6. Davis Weaver N
  7. Swetschinski LR
  8. Wool EE
  9. Han C
  10. Mestrovic T
  11. Ikuta KS
  12. Abbas N
  13. Abbasi M
  14. Abd Elhafeez S
  15. Abdisa WM
  16. Abdoun M
  17. Abdullahi A
  18. Abebe M
  19. Abejew AA
  20. Abie A
  21. Abolhassani H
  22. Abukhadijah HJ
  23. Achore M
  24. Adams LC
  25. Adedokun KA
  26. Adesola RO
  27. Adiga U
  28. Adnani QES
  29. Afolabi AA
  30. Agyemangduah W
  31. Ahadi M
  32. Ahmad A
  33. Ahmed GS
  34. Ahmed H
  35. Ahmed MS
  36. Ahmed SA
  37. Akter E
  38. Alansari A
  39. Albashtawy M
  40. Aleidi SM
  41. Alemnew F
  42. Algammal AM
  43. Alhumaydhi FA
  44. Ali MU
  45. Ali R
  46. Ali SS
  47. Aliede M
  48. Aljabi SW
  49. Almarwani S
  50. Alniss HY
  51. Alosta MR
  52. Alqudimat MR
  53. Alqudimat AR
  54. Alrawashdeh A
  55. Alrimawi I
  56. Alrousan SM
  57. Alshahrani NZ
  58. Alvisguzman N
  59. Alworafi YM
  60. Aly H
  61. Alzubayer MA
  62. Anagnostakis F
  63. Anvari S
  64. Anwer R
  65. Anyasodor AE
  66. Arooj M
  67. Aryntayeva N
  68. Ashraf T
  69. Asmare Z
  70. Assefa RL
  71. Atreya A
  72. Atta JA
  73. Aujayeb A
  74. Azargoonjahromi A
  75. Aziz SA
  76. Azzolino D
  77. Badran AA
  78. Balakrishnan S
  79. Balcha WF
  80. Banik R
  81. Bante SA
  82. Barqawi HJ
  83. Barrow A
  84. Basharat Z
  85. Bassat Q
  86. Bastan MM
  87. Batiha AM
  88. Bauckneht M
  89. Belayneh AG
  90. Belge Bilgin G
  91. Bello UM
  92. Benzian H
  93. Berihun AA
  94. Bhardwaj N
  95. Bhargava A
  96. Bhaskar S
  97. Bhutta ZA
  98. Bitar AN
  99. Borhany H
  100. Borran M
  101. Bouaoud S
  102. Bui LP
  103. Busch F
  104. Bustanji Y
  105. Camera LA
  106. Capodici A
  107. Chakraborty C
  108. Chapuma CIJ
  109. Chaurasia A
  110. Chen H
  111. Chong B
  112. Chopra H
  113. Choudhari SG
  114. Chu DT
  115. Chutiyami M
  116. Cosma C
  117. Cruzmartins N
  118. Dabbagh A
  119. Dai X
  120. Danna L
  121. Davletov D
  122. Dehadrai A
  123. Desai HD
  124. Devanbu VGC
  125. Dhania NK
  126. Dhingra S
  127. Di Pumpo M
  128. Dohare S
  129. Doria M
  130. Dorostkar F
  131. Dowou RK
  132. Dresse MT
  133. Edinur HA
  134. Eighaei Sedeh A
  135. Ekundayo TC
  136. El Arab RA
  137. Eldegwi M
  138. Elhadi M
  139. Elkannishy S
  140. Elnaem MH
  141. Elshaer M
  142. Elsohaby I
  143. Eltaha C
  144. Emami Zeydi A
  145. Eva FN
  146. Fadavian H
  147. Fagbamigbe AF
  148. Farooq SMY
  149. Farsakoury R
  150. Fazylov T
  151. Fekadu G
  152. Femoe UM
  153. Fleischmannstruzek C
  154. Foroutan B
  155. Foschi M
  156. Gadanya MA
  157. Gajdacs M
  158. Ganesan B
  159. Garciaazorin D
  160. Garlasco J
  161. Gautam RK
  162. Gebre FS
  163. Gebremeskel TG
  164. George NS
  165. Gete KY
  166. Ghaffari K
  167. Ghamarnejad O
  168. Gharaibeh L
  169. Ghoba S
  170. Gholamrezanezhad A
  171. Gil AU
  172. Girombelli A
  173. Golinelli D
  174. Golmohammadi M
  175. Grada A
  176. Guarducci G
  177. Gudeta MD
  178. Gulati A
  179. Gunawardane DA
  180. Gupta AK
  181. Gutierrezmurillo RS
  182. Hadaro TS
  183. Halil HMM
  184. Harboe ZB
  185. Hasan MK
  186. Hawes SE
  187. Hay SI
  188. Hemmati M
  189. Hiraike Y
  190. Holla R
  191. Holler JG
  192. Hostiuc S
  193. Hsieh VCR
  194. Huang J
  195. Hussein AM
  196. Hussein NR
  197. Ibrayeva A
  198. Ikiroma A
  199. Ilic IM
  200. Ilic MD
  201. Ismail F
  202. Ismoldayev Y
  203. Jaiswal V
  204. Jalloh M
  205. Javidnia J
  206. Jeong S
  207. Jomehzadeh N
  208. Jyoti A
  209. Kakkar AK
  210. Kalra S
  211. Kamal M
  212. Kankam SB
  213. Karajizadeh M
  214. Karpinski TM
  215. Kasraei H
  216. Kebede FA
  217. Khan M
  218. Khatatbeh H
  219. Khatatbeh MM
  220. Kheradmand D
  221. Khosla AA
  222. Khosravi S
  223. Khosrowjerdi M
  224. Khurana S
  225. Kim K
  226. Kissoon N
  227. Kolahi AA
  228. Koulmane Laxminarayana SL
  229. Kretchy JP
  230. Kuddus M
  231. Kuitunen I
  232. Kumar J
  233. Kumar SK
  234. Kumar T
  235. Kumar V
  236. Kundu S
  237. Kurmanova A
  238. Kurpad KP
  239. Kyto V
  240. Lai H
  241. Lakanova B
  242. Landires I
  243. Le HTT
  244. Ledda C
  245. Leivaditis V
  246. Lin J
  247. Liu V
  248. Llanaj E
  249. Lubinda J
  250. Lucchetti G
  251. Lytras MD
  252. Lytvyak E
  253. Ma KSK
  254. Mabrok M
  255. Mahmood NH
  256. Makram AM
  257. Mannethodi K
  258. Manzoor S
  259. Markazi Moghadam H
  260. Martinsmelo FR
  261. Marzo RR
  262. Marzouk S
  263. Mathangasinghe Y
  264. Mayaki S
  265. Mehto S
  266. Menezes GA
  267. Mengstie LA
  268. Mettananda S
  269. Mohammad T
  270. Mohammadi A
  271. Mohammadzadeh I
  272. Mohan S
  273. Mohsenzadeh A
  274. Mokdad AH
  275. Mollaei A
  276. Monasta L
  277. Moni MA
  278. Morsy MM
  279. Mozahheb Yousefi K
  280. Mulatu S
  281. Mulita F
  282. Murray CJL
  283. Musa S
  284. Mushtaq A
  285. Mustafa G
  286. Muthu S
  287. Naga Rajeev L
  288. Naghavi P
  289. Naik H
  290. Najmuldeen HHR
  291. Nashwan AJ
  292. Nassar M
  293. Nazripanjaki A
  294. Nega AT
  295. Negoi I
  296. Negoi RI
  297. Nepal S
  298. Netsere HB
  299. Ngabonziza JCS
  300. Nikravangolsefid N
  301. Noor STA
  302. Nriezedi CA
  303. Nyande FK
  304. Oancea B
  305. Okeke SR
  306. Okesanya OJ
  307. Olorukooba AA
  308. Olusanya BO
  309. Onyeaghala CA
  310. Opitz M
  311. Ortizprado E
  312. Osborne A
  313. Othman EH
  314. Otorkpa OJ
  315. Ouyahia A
  316. Owusu IA
  317. Oyelade T
  318. Palicz T
  319. Panda SK
  320. Pantazopoulos I
  321. Parekh U
  322. Parvar SY
  323. Pasovic M
  324. Passera R
  325. Patil S
  326. Patoulias D
  327. Pawar S
  328. Perera N
  329. Petcu IR
  330. Pham HN
  331. Pirera E
  332. Poddighe D
  333. Poluru R
  334. Pourghazi F
  335. Puvvula J
  336. Qamar MU
  337. Qasim NH
  338. Qian G
  339. Rabiee N
  340. Rahman FM
  341. Rahmoune H
  342. Raimondo D
  343. Rajabi E
  344. Ramadan MM
  345. Ramasamy C
  346. Ramasamy SK
  347. Randolph AG
  348. Ranjbar Noei F
  349. Rao SJ
  350. Rathish D
  351. Rawaf DL
  352. Reyes LF
  353. Rezaeian M
  354. Robles Aguilar G
  355. Rodriguez JAB
  356. Roever L
  357. Rohilla R
  358. Rony MKK
  359. Rosenblad E
  360. Rout HS
  361. Saad AMA
  362. Saad MO
  363. Saeed M
  364. Saeed U
  365. Saha N
  366. Sahoo PM
  367. Saki M
  368. Salaroli LB
  369. Samodra YL
  370. Saravi B
  371. Sarode GS
  372. Sarode SC
  373. Sartorius B
  374. Sathian B
  375. Sattarpour R
  376. Saxena J
  377. Sayeed A
  378. Schinckus C
  379. Schumacher AE
  380. Sengupta P
  381. Serban D
  382. Seyoum AB
  383. Shahab M
  384. Shahrahmani F
  385. Shahwan MJ
  386. Shakeri A
  387. Shakoor S
  388. Shamshirgaran MA
  389. Shan D
  390. Sharifan A
  391. Sharifi Rad J
  392. Sharma V
  393. Shastry RP
  394. Shawahna R
  395. Shetty M
  396. Shittu A
  397. Shivarov V
  398. Shool S
  399. Simpson CR
  400. Singh H
  401. Singh K
  402. Singh P
  403. Singh S
  404. Sinha R
  405. Siyoum DF
  406. Skryabin VY
  407. Soliman AM
  408. Soliman MMS
  409. Soliman NS
  410. Soraneh S
  411. Srichawla BS
  412. Srivastava DB
  413. Stanaway JD
  414. Stergachis A
  415. Subramaniyan V
  416. Suleiman AG
  417. Sun J
  418. Szarpak L
  419. Talukdar JR
  420. Tamuzi JL
  421. Tan KK
  422. Temsah MH
  423. Thangaraju P
  424. Thangavelu L
  425. Thayumana Sundaram M
  426. Ticoalu JHV
  427. Tiruye TY
  428. Tleshev M
  429. Tomo S
  430. Tovanipalone MR
  431. Tran QTH
  432. Tran TH
  433. Tran Minh Duc N
  434. Tuglo LS
  435. Ullah S
  436. Umar UM
  437. Upadhyay E
  438. Usman JS
  439. Uzuncibuk H
  440. Vaithinathan AG
  441. Venkatesh B
  442. Verma A
  443. Veroux M
  444. Verras GI
  445. Villafane JH
  446. Villani L
  447. Vizzielli G
  448. Waheed Y
  449. Wang Y
  450. West TE
  451. Wicaksana AL
  452. Wickramasinghe DP
  453. Wireko AA
  454. Yadav MK
  455. Yadav V
  456. Yasufuku Y
  457. Yaya S
  458. Ye P
  459. Yezli S
  460. Yin D
  461. Yon DK
  462. Yuce D
  463. Zaghampour M
  464. Zakham F
  465. Zamagni G
  466. Zamora N
  467. Zastrozhin M
  468. Zheng DX
  469. Zhumagaliuly A
  470. Zumla A
  471. Zyoud SH
  472. Naghavi M

Source: The Lancet Global Health Published:2025


Abstract

Background: The global burden of sepsis, a life-threatening dysregulated host response to infection leading to organ dysfunction, remains challenging to quantify. We aimed to comprehensively estimate the global, regional, and national burden of sepsis, including the impact of the COVID-19 pandemic and underlying causes of sepsis-related deaths with co-occurring infectious syndromes. Methods: We used multiple cause-of-death, hospital, minimally invasive tissue sampling, and linked death certificate and hospital record data representing 149 million deaths, covering 4290 location-years with mortality estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to capture explicit and implicit sepsis cases and deaths. We estimated age-location-sex-specific fractions of sepsis-related deaths from 195 underlying causes of death and 22 infectious syndromes from 1990 to 2021 using binomial logistic regression models, and estimated sepsis-related deaths using GBD cause-specific mortality estimates. Using 250 million hospital admissions and 7·82 million deaths from hospital data, representing 1310 location-years, we modelled case fatality rates by use of binomial logistic regression, applied to sepsis death estimates to estimate sepsis incidence by age, location, and year. Findings: In 2021, we estimated 166 million (95% uncertainty interval 135–201) sepsis cases and 21·4 million (20·3–22·5) all-cause sepsis-related deaths globally, representing 31·5% of total global deaths. Sepsis-related deaths decreased between 1990 and 2019, followed by a surge in 2020 and 2021. As of 2021, individuals aged 15 years and older experienced increases across incidence (230%) and mortality (26·3%) since 1990. Those aged 70 years and older had the highest sepsis-related mortality in 2021 (9·28 million [8·74–9·86] deaths). Sepsis-related deaths from infectious underlying causes decreased from 11·8 million (11·1–12·5) in 1990 to 8·34 million (7·72–9·01) in 2019, then increased by 86·4% to 15·5 million (14·7–16·4) in 2021. Sepsis-related mortality due to non-infectious underlying causes of death increased from 4·69 million (4·35–5·05) in 1990 to 5·81 million (5·40–6·25) in 2021; the leading non-infectious underlying causes of death with sepsis were stroke, chronic obstructive pulmonary disease, and cirrhosis. In 2021, bloodstream infections inclusive of HIV and malaria (3·08 million [2·83–3·35]) and lower respiratory infections inclusive of COVID-19 (11·33 million [1·20–1·47]) were the most prominent infectious syndromes complicating sepsis-related deaths from non-infectious underlying causes, representing a consistent trend since 1990. Interpretation: The global burden of sepsis increased in 2020 and 2021, reversing progress from 1990. Sepsis incidence and mortality increased in people aged 15 years and older, especially those aged 70 years and older, and as a complication of non-infectious underlying causes of death such as stroke, primarily through bloodstream infections and lower respiratory infections. The global burden of sepsis is substantial, and sepsis is increasingly a complication of non-infectious causes of death. Funding: Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund. © 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/