Mortality trends for sepsis and septic shock among critically ill adults in Australia and New Zealand
Date
2025
Authors
Poole, A.P.
Chaba, A.
Bellomo, R.
Bailey, M.
Deane, A.
Delaney, A.
Eastwood, G.
Haines, K.
Hammond, N.
Hensman, T.
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Journal article
Citation
Intensive Care Medicine, 2025; 51(12):2318-2328
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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, on behalf of The National Critical Care Research Platform Investigators, (NCCR)
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Abstract
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.
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© 2025 Springer-Verlag GmbH Germany, part of Springer Nature.