Spain's ICU Society estimates 17,000 sepsis deaths vs INE's 3,212

Sepsis: 17,000 annual deaths versus 3,212 from the INE

How many people die each year from sepsis in Spain? It depends on who you ask, and that is where the confusion begins. The Spanish Society of Intensive Care Medicine (SEMICYUC) argues that the figure is around 17,000 deaths per year. The National Statistics Institute (INE) recorded 3,212 deaths from septicemia in 2022. Five times fewer. Intensivist David Andaluz, coordinator of SEMICYUC's Infectious Diseases and Sepsis working group, admits he was unaware of this gap and attributes it to a coding failure: if a patient dies from pneumonia with sepsis, the final record may simply say pneumonia.

Why sepsis disappears from official records

The problem starts with the definition itself. Sepsis is an syndrome, not a disease, which is why it is associated with very different pathologies and barely generates comparable epidemiological studies. Although Homer mentioned it in a verse of the Iliad, its definition has changed over time: the latest one, from 2015, refers to organ failure in a patient with an infection, and some consider this insufficient. The INE data closest to scientific society figures is from 2015, with 4,182 deaths from sepsis.

Why have diagnoses increased by 60% since 2016?

According to the Ministry of Health's Specialized Healthcare Activity Registry, septicemia diagnoses rose from 30,509 in 2012 to 73,389 in 2022: a 140% increase in a decade. In 2016, the database scope expanded, recording 45,866 cases; since then, the increase has been 60%. Dr. Juan González del Castillo, coordinator of SEMES' Infection Group, explains this through population aging, greater survival rates among cancer patients, and the growing use of immunosuppressive therapies and invasive procedures. Andaluz disagrees on the underlying diagnosis: his impression is that incidence has remained stable and that we are simply diagnosing better now.

Every hour of delay increases mortality by 8%

In sepsis, time is critical. It is estimated that mortality rises by 8% for every hour it takes to administer appropriate treatment, and locating the source is not always easy, especially when the cause is bacterial. In its most severe form, septic shock, mortality approaches 40%, compared to 10% for septicemia. With these figures on the table, sepsis has become the leading cause of admission to intensive care units. The difficulty lies in identifying it: it lacks a symptom guide like heart attacks do, and the presentation varies in each patient, although the most common symptoms range from continuous fever to increased heart rate, fatigue, or loss of appetite. Researcher Eduardo López Collazo admits that the real incidence remains disputed: some studies point to an increase while others suggest stabilization or even a decrease.

Antibiotics: from scarce prescriptions to resistant bacteria

This is where the conversation gets complicated. There are accounts of patients whose infections worsened after receiving, according to their version, late or insufficient treatment: a wound pierced by metal, a stepfather who ended up in surgery losing bone in a finger, an otitis media that led to hearing loss. These are individual experiences, not statistics, and should be read as such. Against them, it is recalled that antibiotics are not sold without a prescription in Spain, which is different from whether they are prescribed or not, and that restraining prescriptions responds to a bigger problem: bacterial resistance, which could also be driving up sepsis incidence. The paradox pointed out is that restriction, intended to curb resistance, sometimes leaves patients waiting while the infection pogre. Also circulating are explanations attributing the phenomenon to supposed immunosuppression caused by vaccines: there is no evidence supporting this thesis.

Hospital hygiene: suspicions without quantifying data

Another line of criticism points to disinfection protocols in operating rooms and healthcare staff discipline. These are general claims made without supporting figures and should not be taken as proven facts. The area where documented improvement is possible is hospital infection control and homogeneous case recording. And there, for now, each institution counts its own.

With this accounting, what is striking is not that sepsis does not have a unique registry in Spain. What is striking is that the system continues to call an syndrome something it still cannot count.