Triumph Over Sepsis: Dramatic Mortality Decline in ANZ ICUs, With a Post-2020 Rebound

link.springer.com December 15, 2025

In a comprehensive analysis of over 2.9 million ICU admissions across 219 Australian and New Zealand intensive care units from 2000 to mid-2023, in-hospital mortality for adult patients with sepsis (per Sepsis-3 criteria) plummeted from 28% in 2000 to a low of 11% in 2020, before rising slightly to 13% in 2023.

This substantial improvement—adjusted odds ratio of 0.48 (95% CI 0.43–0.54)—occurred independently of case-mix changes, with mortality declining rapidly at 1.1% per year until 2013, slowing to 0.3% annually through 2020, and then increasing by 0.9% per year post-2020, likely influenced by the COVID-19 era.

Despite these gains, challenges persist: contemporary mortality reaches 25% in septic shock cases and 20% among those requiring invasive mechanical ventilation, underscoring the ongoing severity of advanced sepsis presentations in critically ill adults.