Health inequalities highlighted in new study linking poverty to risk of sepsis
26 November 2023
People living in deprivation are at greater risk of developing and dying from sepsis, reveals a new study co-funded by HDR UK and led by the University of Manchester.
Sepsis is a life-threatening condition caused by the body’s immune system overreacting to an infection and causing damage to other tissues and organs. It is estimated that 48,000 people die from sepsis each year in the UK, with a quarter of this figure thought to be preventable with timely diagnosis and treatment.
Funded by HDR UK, the UK Health Security Agency, and the National Institute for Health and Care Research, the study looked at what makes people more at risk of developing and dying from sepsis. Through the OpenSAFELY platform, researchers at the University of Manchester analysed 248,767 cases of non-COVID-19 sepsis from January 2019 to June 2022, matched with 1,346,166 controls.
The findings, published in eClinicalMedicine, show that socioeconomic deprivation, having multiple health conditions and learning disabilities were linked to an increased risk of developing non-COVID-19 related sepsis and death within 30 days.
People with the highest levels of socioeconomic deprivation were found to be nearly twice as likely to die from sepsis within 30 days. The study also found that people with learning disabilities were almost four times as likely to develop the life-threatening condition.
People with chronic liver disease were just over three times more likely to develop non-COVID-19 sepsis, and stage 5 chronic kidney disease had over six times the risk. Cancer, neurological disease, immunosuppressive conditions, and having multiple prior courses of antibiotics were also associated with developing non-COVID-19 sepsis.
Co-author Professor Tjeerd van Staa from The University of Manchester said: “This study shows socioeconomic deprivation, comorbidity and learning disabilities are associated with an increased risk of developing non-COVID-19 related sepsis and 30-day mortality in England.
“We think the research provides comprehensive data and findings of relevance to healthcare systems worldwide.
“It underscores the urgent need for sepsis risk prediction models to account for chronic disease status, deprivation status, and learning disabilities, along with infection severity.
“Sepsis remains a global issue of significant concern so understanding its clinical and health inequality risk factors is essential to understanding at-risk cohorts and effective public health mitigations.
“There is an urgent need to improve the prevention of sepsis, including more precise targeting of antimicrobials to higher-risk patients.”
The study also found that the incidence rate of sepsis not caused by COVID-19 decreased during the pandemic. The authors say this could be attributable to a lower chance of getting other, non-COVID-19, infections because of reduced social mixing, as figures rebounded to pre-pandemic levels in April 2021 after national lockdowns had been lifted.