Poor people much more likely to die from sepsis, study finds | Sepsis

Poor people and those with existing health problems are much more likely to die from sepsis, one of the UK’s biggest killers, a study has found.

Sepsis, or blood poisoning, is a potentially fatal condition triggered when the body reacts to an infection by attacking its own tissues and vital organs. It leads to an estimated 48,000 deaths a year in Britain.

Research from the University of Manchester has disclosed for the first time how some groups are at much higher risk of dying from the condition than the general population.

An analysis of 248,767 cases of non-Covid sepsis in England between January 2019 and June 2022 has found that the most deprived people are twice as likely to die from it within 30 days.

The findings, published in the journal eClinicalMedicine, also show that:

People who have cancer, brain disease or immunosuppressive conditions are also at higher risk, as are those who have received multiple courses of antibiotics, the team led by Prof Tjeerd van Staa and Xiaomin Zhong concluded.

“This study shows socioeconomic deprivation, comorbidity and learning disabilities are associated with an increased risk of developing non-Covid related sepsis and 30-day mortality in England.”

The authors say their findings should help health professionals worldwide treating patients who may have sepsis to help diagnose it earlier and start treatment sooner. Clinical staff can struggle to identify sepsis as its symptoms – which include a rash, blotchy skin and slurred speech – are also possible signs of many other illnesses.

Dr Ron Daniels, the founder and joint chief executive of the UK Sepsis Trust, said: “As an intensive care doctor in inner-city Birmingham, I frequently see patients from underrepresented communities presenting late with sepsis.

“This important study reminds us that socioeconomic status and the presence of underlying illness, which are themselves often interlinked and additionally linked to ethnicity, are at play in determining inequality in the risk of developing non-Covid sepsis.”

Last month, the NHS ombudsman said people were dying avoidably because of the health service’s persistent “serious failings” in sepsis and failure to learn lessons in how it handles the condition.

Recurring failings included delays in diagnosing and treating people with sepsis, poor communication and record-keeping, and missed opportunities to provide follow-up care, said Rob Behrens, the ombudsman. The NHS generally “needs to be sepsis-aware”, he added.

Zhong said: “We’re not sure why exposure to multiple courses of antibiotics increases patients’ risk of sepsis.

“But it’s reasonable to speculate that the adverse effects of antibiotics on the beneficial bacteria in the gut could lead to increased susceptibility to infection. It could also be down to underlying differences in immune status or comorbidities.”

A Department of Health and Social Care spokesperson said: “We welcome further research to understand the relationship between health inequalities and the risks of infection, antimicrobial resistance and sepsis.

“There is ongoing work to update guidance on the diagnosis and response to sepsis, meaning the best treatment is always provided quickly, and to ensure that healthcare workers are given sepsis guidance during training.”