COMMENTARY ON THE PUBLISHED SEPSIS FIGURES

The Sepsis Foundation uses the results of the non-representative OPTIMISE study, the results of which were published in the journal Infection, for its statements on the incidence of sepsis in Germany. This study shows that more than 700 per 100,000 inhabitants could be affected by sepsis each year, which amounts to more than 500,000 patients per year in Germany. These figures are in line with recent results from representative studies from the USA and Sweden, which have also identified more than 700 cases of sepsis per 100,000 inhabitants per year.¹

The figures used in the #DeutschlandErkenntSepsis (#DES) campaign, on the other hand, come from the report "Development of a quality assurance procedure 'Diagnostics, therapy and follow-up care of sepsis'" by the Institute for Quality Assurance and Transparency in Healthcare (IQTIG) dated May 31, 2022. These are based on the sepsis cases coded according to ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems) in German hospitals from 2019. However, it can be assumed that the actual number of sepsis cases in Germany is significantly higher, which can be attributed to the following reasons:

• Treating physicians only correctly name around half of the actual sepsis cases in the patient file.²


• In the billing data, which serve as data sources for epidemiological estimates, only a third of the actual cases are recorded using the corresponding ICD codes.²


• Cases of viral sepsis - e.g. as a result of influenza or Covid-19 - are usually not documented as such in the medical records³ and were not even representable in the German ICD-10 before 2023.


• Sepsis that occurs outside of hospital is not recorded, although it is estimated that 14 percent of all deaths caused by sepsis are attributable to these cases.⁴

In Germany, causes of death and illness are not systematically recorded and documented in either the outpatient or inpatient sector. This applies in particular to underestimated diseases such as sepsis, meaning that the actual number of cases can only be estimated. The majority of #DES partners have agreed to use the figures mentioned in the campaign, as these are sufficient, despite their methodological limitations, to illustrate the need for action in terms of better awareness of the preventability, early detection and need for treatment of sepsis as an emergency.

FOOTNOTES