Ashish Bhargava

35788617400

Publications - 1

Global, regional, and national sepsis incidence and mortality, 1990–2021: a systematic analysis

Usha Adiga Samah W. Al-Jabi Meriem Abdoun Quique Bassat Zulfiqar A. Bhutta Hany Aly Ashish Bhargava Hasan Yaser Alniss Razique Anwer Abdul Monim Batiha Asrat Agalu Abejew Samar Abd ElHafeez Mahwish Arooj Matteo Bauckneht Mohammad R. Alqudimat Alok Atreya Abdelazeem M. Algammal Saeid Anvari Auwal Abdullahi Tahira Ashraf Shereen M. Aleidi Mohammad R. Alosta Senthilkumar Balakrishnan Zarrin Basharat Montaha Al-Iede Nasir Abbas Syed Shujait Ali Williams Agyemang-Duah Sahel Majed Alrousan Lucien R. Swetschinski Sonu Bhaskar Anayochukwu Edward Anyasodor Lisa C. Adams Ahmad Naoras Bitar Madineh Abbasi Habib Benzian Intima Alrimawi Nicole Davis Weaver Mohammed Albashtawy Meshack Achore Domenico Azzolino Eve E. Wool Kamoru Ademola Adedokun Fahad A. Alhumaydhi Ahmad Alrawashdeh Aqeel Ahmad Simachew Animen Bante Nelson Alvis-Guzman Umar Muhammad Bello Rafat Ali Kevin S. Ikuta Qorinah Estiningtyas Sakilah Adnani Rajon Banik Amadou Barrow Mina Borran Wondu Feyisa Balcha Chieh Han Gasha Salih Ahmed Aanuoluwapo Adeyimika Afolabi Alaa Aboelnour Badran Anna Gershberg Hayoon Hamed Borhany Nikha Bhardwaj Ahmad Rajeh Al-Qudimat Najim Z. Alshahrani Fentahun Alemnew Mesfin Abebe Md Akib Al-Zubayer Ema Akter Ridwan Olamilekan Adesola Ali Azargoonjahromi Authia P. Gray Mahsa Ahadi Mohammed Usman Ali Zelalem Asmare Hana J. Abukhadijah Alemwork Abie Amani Alansari Asnake Gashaw Belayneh Yaser Mohammed Al-Worafi Filippos Anagnostakis Daniel T. Araki Hassan Abolhassani Sabah Al-Marwani Gokce Belge Bilgin Mohammad Mahdi Bastan Meqdad Saleh Ahmed Rebecca L. Hsu Abiye Assefa Berihun Erin Chung Hiba Jawdat Barqawi Julie Alaere Atta Nurila Aryntayeva Wakgari Mosisa Abdisa Redeat Libanos Assefa Syed Anees Ahmed Haroon Ahmed Sadat Abdulla Aziz Avinash Aujayeb Tomislav Mestrovic

Publication Name: Lancet Global Health

Publication Date: 2025-12-01

Volume: 13

Issue: 12

Page Range: e2013-e2026

Description:

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.

Open Access: Yes

DOI: 10.1016/S2214-109X(25)00356-0