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Purpose <p>Sepsis is a major cause of mortality in intensive care unit (ICU) patients. Significant temporal improvements in survival were observed in Australia and New Zealand (ANZ) from 2000 to 2012. Whether this has continued remains uncertain, and current sepsis-related mortality in ANZ ICUs is unknown.</p> Methods <p>We studied adult ICU patients admitted with sepsis (based on the 3rd international consensus definition for sepsis and septic shock), between January 2000 and June 2023. Data were obtained from 219 ICUs that contributed to the ANZ Intensive Care Society Adult Patient Database. We used logistic regression models to study changes in in-hospital mortality over time.</p> Results <p>Among 2,975,149 ICU admissions, 303,389 patients had sepsis. In-hospital mortality was 28% in 2000, falling to 13% in 2023 (adjusted OR 0.48; 95% confidence interval [CI] 0.43 to 0.54). Mortality decreased at a rate of 1.1% per year between 2000–2013, 0.3% per year between 2013–2020 (<i>p</i> &lt; 0.001 for change in slope), and increased 0.9% per year between 2020–2023 (<i>p</i> &lt; 0.001). A nadir of 11% was observed in 2020. Modelled linearly, in-hospital mortality decreased 4% per year from 2000 to 2020, independent of measurable confounding. Contemporary in-hospital mortality was 25% in those with septic shock, and 20% in those receiving invasive mechanical ventilation.</p> Conclusions <p>In-hospital mortality in adult ANZ ICU patients admitted with sepsis decreased significantly from 28% in 2000 to a nadir of 11% in 2020, independent of changes in case-mix. In-hospital mortality remains substantially higher with septic shock and in those receiving invasive mechanical ventilation.</p>

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Mortality trends for sepsis and septic shock among critically ill adults in Australia and New Zealand

  • 期刊论文

  • 发表日期：

    2025年11月3日

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  • Alexis P. Poole,
  • Anis Chaba,
  • Rinaldo Bellomo,
  • Michael Bailey,
  • Adam Deane,
  • Anthony Delaney,
  • Glenn Eastwood,
  • Kimberley Haines,
  • Naomi Hammond,
  • Tamishta Hensman,
  • Alisa Higgins,
  • Daryl Jones,
  • Zoe McQuilten,
  • Champ Mendis,
  • Ary Serpa Neto,
  • David Pilcher,
  • Manoj Saxena,
  • Kiran Shekar,
  • Kelly Thompson,
  • Paul J. Young,
  • Edward Litton,
  • Andrew A. Udy,
  • David J. Jamie Cooper,
  • Craig French,
  • Carol Hodgson,
  • Ary Serpa Neto,
  • Sandra Peake,
  • Alexis Poole,
  • Andrew Udy,
  • Steve Webb,
  • Jeremy Cohen,
  • Paul Young,
  • Edward Litton,
  • Lewis Campbell

摘要

Purpose

Sepsis is a major cause of mortality in intensive care unit (ICU) patients. Significant temporal improvements in survival were observed in Australia and New Zealand (ANZ) from 2000 to 2012. Whether this has continued remains uncertain, and current sepsis-related mortality in ANZ ICUs is unknown.

Methods

We studied adult ICU patients admitted with sepsis (based on the 3rd international consensus definition for sepsis and septic shock), between January 2000 and June 2023. Data were obtained from 219 ICUs that contributed to the ANZ Intensive Care Society Adult Patient Database. We used logistic regression models to study changes in in-hospital mortality over time.

Results

Among 2,975,149 ICU admissions, 303,389 patients had sepsis. In-hospital mortality was 28% in 2000, falling to 13% in 2023 (adjusted OR 0.48; 95% confidence interval [CI] 0.43 to 0.54). Mortality decreased at a rate of 1.1% per year between 2000–2013, 0.3% per year between 2013–2020 (p < 0.001 for change in slope), and increased 0.9% per year between 2020–2023 (p < 0.001). A nadir of 11% was observed in 2020. Modelled linearly, in-hospital mortality decreased 4% per year from 2000 to 2020, independent of measurable confounding. Contemporary in-hospital mortality was 25% in those with septic shock, and 20% in those receiving invasive mechanical ventilation.

Conclusions

In-hospital mortality in adult ANZ ICU patients admitted with sepsis decreased significantly from 28% in 2000 to a nadir of 11% in 2020, independent of changes in case-mix. In-hospital mortality remains substantially higher with septic shock and in those receiving invasive mechanical ventilation.