Sepsis: The Magnitude of the Problem

The magnitude of sepsis is considerable, affecting some 2–14% of ICU patients depending on the definition used. The impact of this disease process is considerable with mortality rates of around 50% depending on the definition used, and increasing with the degree of sepsis, from sepsis through sever sepsis to septic shock. With the associated morbidity, the economic costs of sepsis are also large. As the numbers of older, more debilitated patients being treated in our ICUs continues to increase, so the incidence of sepsis is increasing. While recent studies have shown some possible reductions in the mortality from sepsis, we cannot afford to be complacent. Definitions based on syndromes need to be replaced by more specific, mechanism-based entities reflecting the immunologic or biochemical changes seen in sepsis [18]; using such definitions to select more homogeneous patient populations for clinical trials, in combination with organ dysfunction scores to assess outcome, will lead to the development of effective new therapies, and the high costs of sepsis, in terms of mortality and finance, will be reduced.