Awareness and management of sepsis among emergency medicine practitioners in China: a national cross-sectional study.

backgroundDespite the efforts of the Surviving Sepsis Campaign over two decades, sepsis remains a leading cause of mortality worldwide, with 19–48.9 million cases and 11 million deaths annually. At present, research on sepsis is predominantly focused within the intensive care unit domain; however, the initial diagnosis of sepsis predominantly occurs in the emergency department. Thus, a national cross-sectional study is needed to assess emergency department healthcare workers’ awareness and treatment of sepsis in China and to evaluate the geographic distributions of sepsis prevalence, in-hospital mortality, and economic burden.

methodsWe conducted a national cross-sectional study to evaluate the cognitive and therapeutic landscape of sepsis among emergency department healthcare workers in China. The study used purposeful sampling in tertiary hospitals across different regions of mainland China. A questionnaire was developed via the Questionnaire Star platform and administered electronically via WeChat and email to physicians across multiple Chinese medical institutions between September 27 and October 31, 2024; multicenter data on sepsis diagnosis patterns, therapeutic interventions, mortality outcomes, and associated economic burdens were collected.

resultsA total of 163 hospital datasets were collected, and after exclusions, 113 eligible hospital datasets were included in the analysis. Regarding the adoption of sepsis diagnostic criteria in emergency departments, the results indicate that northern regions have a significantly greater adoption of Sepsis-3.0 than southern regions do (P = 0.048). There is significant regional variation in the prevalence and in-hospital mortality rates of sepsis across mainland China, with the eastern coastal regions generally having lower sepsis in-hospital mortality rates than the western regions do. The number of patients in the emergency intensive care unit with expenses exceeding 80,000 RMB is nearly double that of the entire hospital. The expenditure range of 21,000–40,000 RMBs has emerged as the predominant cost bracket for hospitalized patients and has been consistently observed across both the emergency intensive care unit and hospital-wide settings.

conclusionIn mainland China, several emergency departments have adopted internationally recognized diagnostic criteria (Sepsis-3.0) for sepsis. However, there is still significant variation in the diagnosis and treatment outcomes of sepsis across different regions, highlighting the urgent need for standardized and homogeneous sepsis management practices. CLINICAL TRIAL NUMBER: Not applicable.