title: Sepsis-related deaths in Brazil: an analysis of the national mortality registry from 2002 to 2010.
abstract: BACKGROUND
  Limited population-based epidemiologic information about sepsis' demography, including its mortality and temporal changes is available from developing countries. We investigated the epidemiology of sepsis deaths in Brazil using secondary data from the Brazilian Mortality Information System.
  
  
  METHODS
  Retrospective descriptive analysis of Brazilian multiple-cause-of-death data between 2002 and 2010, with sepsis-associated International Classification of Diseases, 10th Revision (ICD-10) code indicated as the cause of death. Population-based sepsis associated mortality rates and trends were estimated. Annual population-based mortality rates were calculated using age-stratified population estimates from the 2010 census provided by the Brazilian Institute of Geography and Statistics as denominators.
  
  
  RESULTS
  The total number of annual deaths recorded in Brazil increased over the decade, from 982,294 deaths reported in 2002 to 1,133,761 deaths reported in 2010. The number of sepsis associated deaths also increased both in absolute numbers and proportions from 95,972 (9.77% of total deaths) in 2002 to 186,712 deaths (16.46%) in 2010. The age-adjusted rate of sepsis-associated mortality increased from 69.5 deaths per 100,000 to 97.8 deaths per 100,000 population from 2002 to 2010 (P < 0.001). Sepsis-associated mortality was higher in individuals older than 60 years of age as compared to subjects aged 0 to 20 years (adjusted rate ratio 15.7 (95% confidence interval (CI) 15.6 to 15.8)) and in male subjects (1.15 (95% CI 1.15 to 1.16)).
  
  
  CONCLUSIONS
  Between 2002 and 2010 the contribution of sepsis to all cause mortality as reported in multiple-cause-of-death forms increased significantly in Brazil. Age-adjusted mortality rates by sepsis also increased in the last decade. Our results confirm the importance of sepsis as a significant healthcare issue in Brazil.
authors.affiliation: Research and Education Institute (IEP), Hospital Sirio-Libanes, Rua Cel, Nicolau dos Santos 69, São Paulo, Brazil. leandrout@hotmail.com.|Emergency Medicine Discipline, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, São Paulo, Brazil. leandrout@hotmail.com.
authors.forename: Leandro U
authors.initials: LU
authors.lastname: Taniguchi
authors.affiliation: Research and Education Institute (IEP), Hospital Sirio-Libanes, Rua Cel, Nicolau dos Santos 69, São Paulo, Brazil. albierrenbach@yahoo.com.br.|Sanas Epidemiology and Research, Avenida Paulista 2073, Edifício Horsa 1, salas 703/704, São Paulo, Brazil. albierrenbach@yahoo.com.br.
authors.forename: Ana Luiza
authors.initials: AL
authors.lastname: Bierrenbach
authors.affiliation: Research and Education Institute (IEP), Hospital Sirio-Libanes, Rua Cel, Nicolau dos Santos 69, São Paulo, Brazil. ctoscano@terra.com.br.|Department of Collective Health, Federal University of Goias, Rua 235 s/n, Goias, Brazil. ctoscano@terra.com.br.
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Toscano
authors.affiliation: Research and Education Institute (IEP), Hospital Sirio-Libanes, Rua Cel, Nicolau dos Santos 69, São Paulo, Brazil. gppschettino@uol.com.br.
authors.forename: Guilherme P P
authors.initials: GP
authors.lastname: Schettino
authors.affiliation: Research and Education Institute (IEP), Hospital Sirio-Libanes, Rua Cel, Nicolau dos Santos 69, São Paulo, Brazil. lucianoazevedo@uol.com.br.|Emergency Medicine Discipline, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, São Paulo, Brazil. lucianoazevedo@uol.com.br.
authors.forename: Luciano C P
authors.initials: LC
authors.lastname: Azevedo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011159:Population Surveillance / Q000379:methods; D012042:Registries; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality*