The burden of sepsis in Italy: an analysis of treatable mortality trends

Abstract Background The burden of sepsis, a life-threatening condition triggered by the body’s extreme response to infection, remains a critical global healthcare concern. Sepsis-related deaths often result from delayed recognition, insufficient treatment, or gaps in healthcare delivery. The study aims to analyze treatable mortality for sepsis in Italy and its regions. Methods A retrospective study was conducted on data of treatable mortality for sepsis in Italy and its regions. According to joint OECD/Eurostat list, we included sepsis deaths with the ICD-10 codes A40 (excl. A40.3 [sepsis due to Streptococcus pneumoniae]) and A41 (excl. A41.3 [sepsis due to Hemophilus influenzae]) from 2006 to 2019. Through data on the resident population two-year age-standardized rates by region were calculated. Results From 2006/7 to 2018/9 an overall increase was observed in Italy, from 1.6 to 2.2 age-standardized mortality rates with a maximum peak in 2014/5 (+46.7%). This trend was confirmed for Lombardy (+47.8%), Veneto (+48.8%), Emilia-Romagna (+49.3%), Tuscany (52.0%), Marche (+58.4%%), Abruzzo (39.4%), Molise (26.7%), Apulia (+57.0%), Sicily (+57.2%), and Sardinia (+46.8%). Aosta Valley (+72,5%) had a maximum peak in 2010/1, while Piedmont (+42.5%), Autonomous Province (A.P.) of Bolzano (+27.8%), A.P. of Trento (+45.0%), Friuli-Venezia Giulia (+23.3%) in 2012/3, Calabria (+46.4%) in 2016/7 and lastly Campania (+52.9%) and Basilicata (+73.0%) in 2018/9. Liguria (+49.8%), Latium (47.2%) and Umbria (49.3%) showed two maximum values, one in the 2012/3 and the other in the 2014/5. Conclusions We observed an overall increase in age-standardized mortality rates throughout Italy, with a peak in 2014/5. This trend was resumed in ten regions, while three regions showed multiple peaks, indicating fluctuations in mortality rates. These findings underline the importance of targeted health interventions and policy initiatives to address region-specific health challenges. Key messages • Regional disparities in mortality rates highlight the necessity for customized health interventions and policy measures between Italian regions. • Recognizing fluctuating mortality trends in specific regions is crucial to effectively address various health challenges.