Hospital admissions for sepsis rose significantly between 2000 and 2019, with infants, people over 70, Māori and Pacific peoples and those living in areas of deprivation at much higher risk of developing the condition, researchers at the University of Otago, Wellington – Ōtākou Whakaihu Waka, Pōneke, have found.
Sharla McTavish
The research, led by Sharla McTavish, a Tangata Tiriti PhD candidate from the Department of Public Health, found hospitalisation rates increased by 78 per cent over the 20-year study period, from 217 admissions per 100,000 people in 2000 to 386 admissions per 100,000 people in 2019.
Māori and Pacific peoples were 1.7 and 2.3 times, respectively, more likely to be hospitalised with sepsis than those of non-Māori, Pacific or Asian descent, and more than one-and-a-half times more likely to die of the condition. Patients living in areas of high socioeconomic deprivation were twice as likely to die from the condition than those from the least deprived socioeconomic areas.
Sepsis is an acute, life-threatening condition that happens when the body's immune system has an extreme response to an infection, damaging the tissues and organs. Globally, sepsis is estimated to be responsible for one in three deaths, with more than 166 million cases reported in 2021.
The Otago study is the first to report long-term epidemiological trends for all public hospital admissions for sepsis in Aotearoa New Zealand. The findings are published in the international medical journal, The Lancet Regional Health – Western Pacific.
"People living with multiple long-term health conditions are at higher risk of developing sepsis, and where this is combined with inequalities, such as household overcrowding, the risk increases even more." – Sharla McTavish
Sharla says sepsis has had a large impact on health and wellbeing in Aotearoa.
"There were approximately 260,000 hospitalisations for sepsis, and 27,400 deaths over the two decades. That's almost five per cent of the total mortality in Aotearoa over that period, and if you compare it to motor vehicle fatalities, it's almost four times as many deaths."
She says that while the number of hospitalisations increased significantly in Aotearoa over the 20-year period, the number of deaths had remained comparatively stable, with survival rates improving markedly, particularly for those aged over 70.
Sharla says sepsis cases are likely to continue to rise as the population ages and the number of people living with chronic conditions such as diabetes, increases.
"People living with multiple long-term health conditions are at higher risk of developing sepsis, and where this is combined with inequalities, such as household overcrowding, the risk increases even more."
Professor Michael Baker
Otago public health Professor Michael Baker, who is one of the study authors, says with sepsis responsible for almost five per cent of deaths in Aotearoa, taking action to prevent the condition should be high on the Government's list of priorities.
"Many cases and deaths from sepsis are preventable, but we need to use all the public health measures we have to combat the toll it is taking on New Zealand families."
A Public Health Expert Briefing published today summarises the main findings of the research and outlines the measures that Aotearoa could take to prevent and manage sepsis.
Sepsis Trust NZ Founding Trustee Dr Paul Huggan says the burden of sepsis in Aotearoa is significant.
"Around one in five sepsis patients require intensive or high dependency care, yet only half receive treatment within the recommended three-hour window, which is well below global best practice, and is putting lives at risk.
"We have strong international evidence which shows investing in early recognition and prevention will reduce hospital stays, ease pressure and costs on ICU and our ACC system, and deliver strong economic returns," he says.
Sepsis Trust NZ CEO Ally Hossain says despite strong support from frontline clinicians, progress is being held back by a lack of coordinated action.
"We need to urgently address the growing and inequitable burden on our healthcare system and communities through a long-term, comprehensive National Sepsis Action Plan.
"This plan must address sepsis prevention, early recognition and treatment, the careful use of antibiotics and wider public health surveillance, as well as providing equitable and effective wraparound support for sepsis survivors, particularly in the first 12 months following hospital discharge.
"We are already falling behind comparable countries in recognising and treating sepsis and, as we can see from our news headlines, that failure to follow suit is costing lives," she says.
Publication details
The research paper, 'Temporal trends in sepsis hospitalisations and mortality in Aotearoa New Zealand, 2000-2019' is published in The Lancet Regional Health – Western Pacific.
A Public Health Expert Briefing on the study, 'Increasing sepsis burden and persistent inequities demand national response'.
