Cited by 5,841Sepsis Diagnosis and TreatmentNeonatal and Maternal InfectionsBacterial Infections and Vaccines

The DOI matches its Crossref record; 47 of the 48 references it cites were found in a registry or an index.

The Epidemiology of Sepsis in the United States from 1979 through 2000

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Martin, Greg S., Mannino, David M., Eaton, Stephanie, Moss, Marc·2003·New England Journal of Medicine

Abstract

BACKGROUND: Sepsis represents a substantial health care burden, and there is limited epidemiologic information about the demography of sepsis or about the temporal changes in its incidence and outcome. We investigated the epidemiology of sepsis in the United States, with specific examination of race and sex, causative organisms, the disposition of patients, and the incidence and outcome. METHODS: We analyzed the occurrence of sepsis from 1979 through 2000 using a nationally representative sample of all nonfederal acute care hospitals in the United States. Data on new cases were obtained from hospital discharge records coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification. RESULTS: Review of discharge data on approximately 750 million hospitalizations in the United States over the 22-year period identified 10,319,418 cases of sepsis. Sepsis was more common among men than among women (mean annual relative risk, 1.28 [95 percent confidence interval, 1.24 to 1.32]) and among nonwhite persons than among white persons (mean annual relative risk, 1.90 [95 percent confidence interval, 1.81 to 2.00]). Between 1979 and 2000, there was an annualized increase in the incidence of sepsis of 8.7 percent, from about 164,000 cases (82.7 per 100,000 population) to nearly 660,000 cases (240.4 per 100,000 population). The rate of sepsis due to fungal organisms increased by 207 percent, with gram-positive bacteria becoming the predominant pathogens after 1987. The total in-hospital mortality rate fell from 27.8 percent during the period from 1979 through 1984 to 17.9 percent during the period from 1995 through 2000, yet the total number of deaths continued to increase. Mortality was highest among black men. Organ failure contributed cumulatively to mortality, with temporal improvements in survival among patients with fewer than three failing organs. The average length of the hospital stay decreased, and the rate of discharge to nonacute care medical facilities increased. CONCLUSIONS: The incidence of sepsis and the number of sepsis-related deaths are increasing, although the overall mortality rate among patients with sepsis is declining. There are also disparities among races and between men and women in the incidence of sepsis. Gram-positive bacteria and fungal organisms are increasingly common causes of sepsis.

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  1. 1990, MMWR Morb Mortal Wkly Rep, 39, 31
  2. Eaton S, 2002, Am J Respir Crit Care Med, 165, A471

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Metadata

Authors
Martin, G. S., Mannino, D. M., Eaton, S., & Moss, M.
Affiliations
  • Emory University (US)
  • Centers for Disease Control and Prevention (US)
Venue
New England Journal of Medicine
Published
2003-04-17
Volume
348
Issue
16
Pages
1546-1554
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2145577370
Cited by
5,841
References
48
Citations by year
2026: 67 · 2025: 128 · 2024: 149 · 2023: 168 · 2022: 167 · 2021: 253 · 2020: 231 · 2019: 211 · 2018: 226 · 2017: 329 · 2016: 292 · 2015: 341 · 2014: 381 · 2013: 436 · 2012: 365
FWCI
123.48
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • UKnowledge (University of Kentucky) (submittedVersion)
Funders
  • National Institute on Alcohol Abuse and Alcoholism (AA R01-11660, R01AA011660)
  • National Heart, Lung, and Blood Institute (K23HL067739, HL K23-67739)
  • National Center for Research Resources (L30 RR020488)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
PSIS, sepsis incidence, sepsis mortality, temporal trends, racial disparities, sex differences, Gram-positive bacteria, fungal infection, sepsis pathogens, organ failure, length of hospital stay, hospital discharge disposition, Black men, hospital discharge data, acute care hospitals, healthcare burden
MeSH terms
Female, Humans, Male, Middle Aged, Multiple Organ Failure, Sex Factors, United States, Incidence, Survival Rate, Hospital Mortality, Sepsis, Racial Groups

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