SynthesisCritical care (London, England)2019
Trends in sepsis mortality over time in randomised sepsis trials: a systematic literature review and meta-analysis of mortality in the control arm, 2002-2016.
Synthesis in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Sepsis mortality prediction using machine learning and deep learning - a systematic review.BMC medical informatics and decision making · 2025Pooled it
- All-cause mortality in cancer patients treated for sepsis in intensive care units: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Pooled it
- The Role and Efficacy of Vitamin C in Sepsis: A Systematic Review and Meta-Analysis.Advances in respiratory medicine · 2022Pooled it
- Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019- results from a systematic review and meta-analysis.Critical care (London, England) · 2020Pooled it
- Clinical and Immunologic Effects of Extracorporeal Cytokine Removal in Patients with Septic Shock: A Randomized Controlled Trial.Shock (Augusta, Ga.) · 2026Trial
- Activity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years.Antibiotics (Basel, Switzerland) · 2026Article
- Renal dysfunction as a marker of adverse outcomes in early sepsis in the emergency department.Clinical and experimental emergency medicine · 2026Article
- Myeloid-Derived Suppressor Cells in Sepsis: Pathophysiology, Duality, and Therapeutic Frontiers.Shock (Augusta, Ga.) · 2026Review
- Disease Trends and Mortality From Invasive Pneumococcal Disease: A Long-Term Population-Based Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Role of the ionized-to-total calcium ratio in predicting sepsis mortality: a retrospective analysis from the MIMIC-IV database.BMC infectious diseases · 2026Article
- Albumin-Anchored Composite Ratios of Blood Urea Nitrogen, C-Reactive Protein, Lactate, and Creatinine for Predicting Mortality in Chronically Ill Intensive Care Unit Patients.Journal of clinical medicine · 2026Article
- Machine Learning Models for Sepsis: From Early Detection to Short- and Long-Term Prognosis.International journal of molecular sciences · 2026Article
- Impact of prehospital antibiotic therapy differs depending on septic shock origin.Journal of intensive care · 2026Article
- Association between corrected serum calcium levels and 28-day mortality in patients with sepsis: A cohort study.Medicine · 2026Article
- Prehospital Care Duration and 30-Day Mortality Among Septic Shock.Emergency medicine international · 2026Article
- Nationwide trends and disparities in deaths following cardiogenic shock and sepsis in the United States (1999-2023): insights from the CDC WONDER database.BMC cardiovascular disorders · 2025Article
- Article
- Accuracy of the modified Global Burden of Disease International Classification of Diseases coding methods for identifying sepsis: a prospective multicentre cohort study.Critical care (London, England) · 2025Observational
- Advancing sepsis diagnosis and immunotherapy machine learning-driven identification of stable molecular biomarkers and therapeutic targets.Scientific reports · 2025Article
- Exploring Core Genes Associated with Sepsis and Systemic Inflammatory Response Syndrome Using Single-Cell Sequencing Technology.Journal of inflammation research · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEpidemiologic data have shown an increasing incidence and declining mortality rate in sepsis. However, confounding effects due to differences in disease classification might have contributed to these trends. To assess if a declining mortality over time could be supported by data derived from high-quality prospective studies, we performed a meta-analysis using data from randomised controlled trials (RCTs) on sepsis. The primary aim was to assess whether the mortality in sepsis trials has changed over time. The secondary aim was to investigate how many of the included trials could show efficacy of the studied intervention regarding 28-day mortality.
methodsWe searched PubMed for RCTs enrolling patients with severe sepsis and septic shock, published between 2002 and 2016. The included trials were assessed for quality and sorted by date of first inclusion. A meta-analysis was performed to synthesise data from the individual sepsis trials.
resultsOf 418 eligible articles, 44 RCTs on sepsis were included in the analysis, enrolling 13,315 patients in the usual care arm between 1991 and 2013. In this time period, mortality decreased by 0.42% annually (p = 0.04) to give a total decline of 9.24%. In subgroup analyses with adjustments for APACHE II, SAPS II and SOFA scores, the observed time trend was not significant (p = 0.45, 0.23 and 0.98 respectively). Only four of the included trials showed any efficacy with regard to mortality.
conclusionsData from RCTs show a declining trend in 28-day mortality in severe sepsis and septic shock patients during the years from 1991 to 2013. However, when controlling for severity at study inclusion, there was no significant change in mortality over time. The number of trials presenting new treatment options was low.
trial registrationPROSPERO CRD42018091100 . Registered 27 August 2018.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.