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Type: Journal article
Title: Sepsis in the tropical Top End of Australia's Northern Territory: disease burden and impact on Indigenous Australians
Author: Davis, J.
Cheng, A.
Mcmillan, M.
Humphrey, A.
Stephens, D.
Anstey, N.
Citation: Medical Journal of Australia, 2011; 194(10):519-524
Publisher: Australasian Medical Publishing Company Ltd
Issue Date: 2011
ISSN: 0025-729X
Statement of
Joshua S Davis, Allen C Cheng, Mark McMillan, Alex B Humphrey, Dianne P Stephens and Nicholas M Anstey
Abstract: Objective: To describe the clinical and epidemiological features of sepsis and severe sepsis in the population of the tropical Top End of the Northern Territory of Australia and compare these with published estimates for temperate Australia, the United States and Europe. Design, setting and participants: Prospective cohort study in the major hospital for tropical NT, a region where 27% of the population are Indigenous. We screened all adult (≥ 15 years) acute hospital admissions over a 12-month period (6 May 2007 – 5 May 2008) for sepsis by standard criteria, and collected standardised clinical data. Main outcome measures: Population-based incidence of community-onset sepsis and severe sepsis requiring intensive care unit (ICU) admission; 28-day mortality rate and microbial epidemiology. Results: There were 1191 hospital admissions for sepsis in 1090 patients, of which 604 (50.7%) were Indigenous people; the average age was 46.7 years. The age-adjusted annual population-based incidence of sepsis was 11.8 admissions per 1000 (mortality rate, 5.4%), but for Indigenous people it was 40.8 per 1000 (mortality rate, 5.7%). For severe sepsis requiring ICU admission, the incidence was 1.3 per 1000 per year (mortality rate, 21.5%), with an Indigenous rate of 4.7 per 1000 (mortality rate, 19.3%). Conclusions: The incidence of sepsis in the tropical NT is substantially higher than that for temperate Australia, the United States and Europe, and these differences are mainly accounted for by the high rates of sepsis in Indigenous people. The findings support strategies to improve housing and access to health services, and reduce comorbidities, alcohol and tobacco use in Indigenous Australians. The burden of sepsis in indigenous populations worldwide requires further study to guide appropriate resourcing of health care and preventive strategies.
Keywords: Humans
Patient Readmission
Tropical Climate
Middle Aged
Northern Territory
Native Hawaiian or Other Pacific Islander
Rights: Copyright in all material published in the MJA (hard copy) and online at is generally owned by the Australasian Medical Publishing Company (AMPCo, the publisher of the MJA).
DOI: 10.5694/j.1326-5377.2011.tb03088.x
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