Global Research Landscape of Mitochondrial Dysfunction in Sepsis: A Comprehensive Bibliometric and Visualization Analysis (2000-2025).

Objective: Sepsis-associated mitochondrial dysfunction represents a central but incompletely understood mechanism underlying organ failure and mortality in critically ill patients. Despite a growing body of literature, no comprehensive bibliometric analysis has systematically mapped the global research landscape, knowledge structure, and emerging frontiers of this field. This study aimed to quantify publication trends, identify key contributors, delineate thematic hotspots, and characterize the evolving knowledge base in sepsis and mitochondria research over the past 25 years. Methods: A systematic search of the Web of Science Core Collection was conducted using a predefined search strategy combining sepsis- and mitochondria-related terms, restricted to publications from January 1, 2000, to December 31, 2025. After sequential exclusion of retracted publications, non-article/review document types, and non-English records, a final dataset of 3545 publications was obtained. Bibliometric analyses were performed using the bibliometrix package in R, VOSviewer (version 1.6.20), and CiteSpace (version 6.2.R4). Analyses included annual publication trends, geographic and institutional distribution, Bradford's Law journal analysis, Lotka's Law author productivity, co-citation and bibliographic coupling network analysis, thematic mapping, and keyword burst detection. Results: Annual publication output increased more than nine-fold from 2000 to 2025, with a marked acceleration following the 2016 Sepsis-3 consensus definition. China led in publication volume (n = 1350; 38.1%), while the United States demonstrated the highest citation impact (52,732 total citations; 67.61 average citations per publication). Bradford's Law analysis identified 30 core journals, led by Shock, Frontiers in Immunology, and Critical Care Medicine. Lotka's Law analysis confirmed that 74.94% of contributing authors published a single article. The most cited publication was Zhang Q et al (Nature, 2010; 3080 citations). Thematic map analysis identified mitochondrial dysfunction/acute kidney injury, oxidative stress/reactive oxygen species, and inflammation/mitochondrial DNA as Motor Themes. Keyword burst analysis revealed a temporal evolution from early nitric oxide and cytochrome c research toward current hotspots including NLRP3 inflammasome activation, sepsis-associated encephalopathy, and sepsis-induced cardiomyopathy. Conclusion: This comprehensive bibliometric analysis provides a systematic overview of 25 years of research at the intersection of sepsis and mitochondrial biology. The field is experiencing sustained growth, with current research frontiers focused on organ-specific mitochondrial injury, innate immune regulation, and neurological complications.