1 in 5 deaths worldwide linked to sepsis, double previous estimates

TORONTO — For too long the global medical community has “grossly underestimated” the number of deaths connected with sepsis, a largely preventable condition that disproportionately affects young children in the world’s poorest countries, according to a Canadian doctor involved in new international research.

New analysis published in The Lancet on Thursday found that in 2017, 11 million people died in connection with sepsis, a condition that occurs when the body’s reaction to infection begins to damage its own tissue. Sepsis can occur in a number of ways, but researchers found lower respiratory infection like pneumonia – was the most common underlying cause.

That accounts for one in five deaths worldwide, outpacing cancer and heart disease, and is twice as prevalent as previously believed.

Dr. Tex Kissoon, a pediatric professor at the University of British Columbia and study co-author, said the new report represents a “seismic shift.”

“We were very surprised by this,” Kissoon told CTVNews.ca in a phone interview on Wednesday. “We did modelling over a period of years and we came to the conclusion that sepsis is indeed more common than we thought.”

An estimated 30,000 deaths can be attributed to sepsis each a year in Canada, but Dr. Kissoon said more needs to be done to understand the full scope.

“What we rely on is forms that are filled out in hospitals … and in many cases the data we’re getting is incomplete,” he said. “So I think in Canada, we really need better data, a better way of capturing it.”

In the past, global estimates for sepsis were difficult to pinpoint because of a distinct lack of information from low-income countries where sepsis is most prevalent. The new analysis includes cases both in and out of hospital, as well as first-of-its-kind modelling to help measure the problem.

“Previous reports were only from hospitalized patients and in a few high-income countries, so it was a very incomplete picture of what sepsis was like in the world,” Dr. Kissoon said.

In 2017, there were 48.9 million cases of sepsis globally. For patients who survive, many face life-altering problems like nightmares, joint pain, fatigue, and impaired-mental functioning. These effects are part of a condition called post-sepsis syndrome.

“We know that 40 per cent of patients with sepsis tend to have long-term disabilities,” Dr. Kissoon said. “It’s an economic loss for a country when you look at the years of life lost and years with disabilities.”

Finding better ways to treat sepsis is also a priority, experts say.

“We really have, aside from antibiotics and intravenous (IV) fluids, we really have no treatments for sepsis and so any study that we do that tries to improve the treatment of patients who are very sick in intensive care units with sepsis is going to make a difference,” said Dr. Alison Fox-Robichaud, a professor of medicine at McMaster University.

Dr. Kissoon’s research has taken him across the world to countries such as Uganda, Kenya and Bangladesh, where he got a first-hand look at the prevalence of sepsis. He is currently involved in a research project in Nunavut, where he said a lack of resources is a serious concern.

“Some of what we learned in Uganda, we’re doing work in Nunavut in children with the same sort of models. So it is an issue that we need to deal with in Canada,” he said.

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