Clinical Scorecard: Trends in Sepsis Epidemiology in Spain: Analysis of Incidence, In-Hospital Mortality, and Healthcare Impact (2017-2022)
At a Glance
Category | Detail |
|---|
Condition | Sepsis |
Key Mechanisms | Population aging, comorbidity burden, COVID-19-related disruption, and changing infection patterns |
Target Population | Hospitalized patients with sepsis in Spain |
Care Setting | Public and private hospitals in Spain |
Key Highlights
Recent estimates cited by the authors suggest approximately 166 million sepsis cases and 21.4 million related deaths annually worldwide.
The study identified 1,187,393 sepsis hospitalizations from 2017 through 2022, with annual cases increasing from 183,971 to 226,884.
Age-adjusted sepsis incidence reached 4.65 per 1,000 inhabitants in 2022, while in-hospital mortality peaked at 23.7% in 2020 and declined to 20.8% in 2022.
Patients had a mean age of 74.3 years, and respiratory and genitourinary infections were the leading infection sources.
The Minimum Basic Data Set captures 99.5% of hospital discharges in Spain, providing broad national coverage.
Guideline-Based Recommendations
Diagnosis
In the study, sepsis was identified by the concurrent presence of infection and organ dysfunction using an algorithm adapted to the Spanish ICD-10-CM.
All 20 diagnostic fields were screened to identify sepsis occurring during hospitalization.
Management
The findings underscore the need for adequate healthcare resource allocation and optimal clinical management for an increasingly older and medically complex patient population.
The authors highlight older patients with multiple comorbidities as a high-risk group in whom prevention and early detection strategies may be particularly important.
Monitoring & Follow-up
Monitor population-adjusted sepsis incidence and in-hospital mortality over time.
Consider trends in infection source, comorbidity burden, healthcare utilization, and antimicrobial resistance when evaluating changes in sepsis epidemiology.
Risks
Advanced age and greater comorbidity burden are important factors associated with sepsis risk and worse outcomes.
Greater numbers of organ failures, higher Charlson Comorbidity Index scores, intensive care unit admission, and invasive mechanical ventilation were independently associated with increased in-hospital mortality.
Patient & Prescribing Data
The study included 1,187,393 sepsis hospitalizations from 2017 through 2022. Patients had a mean age of 74.3 years, and 54.7% were male. Endocrine and metabolic disorders affected 64.3% of patients, respiratory diseases 34.6%, hypertension 33.5%, and diabetes 30.6%.
Respiratory infections accounted for 40.7% of infection sources and genitourinary infections for 40.4%. Documented bacterial resistance increased from 3.39% of sepsis episodes in 2017 to 5.11% in 2022, while documented beta-lactam resistance increased from 2.07% to 3.55%.
Clinical Best Practices
Interpret temporal trends in the context of population aging, comorbidity burden, changing healthcare utilization, antimicrobial resistance, and the effects of the COVID-19 pandemic.
Use caution when interpreting non-COVID-19 trends because excluding COVID-19 cases does not remove indirect pandemic effects such as healthcare-system strain, staffing shortages, altered clinical practices, and delayed presentations.
Recognize that administrative data may be affected by undercoding and cannot distinguish community-acquired from hospital-acquired sepsis in this study.
Prioritize adequate resource planning and clinical management for older, multimorbid patients, who accounted for much of the persistent sepsis burden.
Related Resources & Content
Epidemiological trends in sepsis in Spain: incidence, in-hospital mortality, and healthcare burden (2017-2022) — Rocío López Herrero, Paula Martínez-Jiménez, Daniel Ortiz del Olmo, Rosa Dolores Prieto-Utrera, Rosa Cobo-Zubia, Adrián García-Concejo, Mario Lorenzo-López, Irina Rebollo-Mato, Fernando Vaquerizo-Villar, Rodrigo Poves-Álvarez, Esther Gómez-Sánchez, and Eduardo Tamayo — International Journal of Infectious Diseases — Publication year: 2026; accepted September 14, 2026.
Global, regional, and national sepsis incidence and mortality, 1990-2021: a systematic analysis — Gray AP, Chung E, Hsu RL, Araki DT, Hayoon AG, Weaver ND, et al. — The Lancet Global Health — 2025.
Epidemiology, management and costs of sepsis in Spain (2008-2017): a retrospective multicentre study — Darbà J, Marsà A — Current Medical Research and Opinion — 2020.
Epidemiological trends of sepsis in the twenty-first century (2000-2013): an analysis of incidence, mortality, and associated costs in Spain — Álvaro-Meca A, Jiménez-Sousa MA, Micheloud D, Sánchez-López A, Heredia-Rodríguez M, Tamayo E, et al. — Population Health Metrics — 2018.
Surviving sepsis campaign research priorities 2023 — De Backer D, Deutschman C, Hellman J, Myatra S, Ostermann M, Prescott H, et al. — Critical Care Medicine — 2024.
Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: a two-cohort study in 2005 and 2011 — Sánchez B, Ferrer R, Suarez D, Romay E, Piacentini E, Gomà G, et al. — Medicina Intensiva — 2017.
Hospital-related costs of sepsis around the world: a systematic review exploring the economic burden of sepsis — van den Berg M, van Beuningen FE, ter Maaten JC, Bouma HR — Journal of Critical Care — 2022.
