Sepsis risk factors: who is more likely to get sepsis

What sepsis is

Sepsis is the body's overactive and extreme response to an infection. Without quick treatment it can lead to tissue damage, organ failure and death (MedlinePlus). It happens when an infection you already have sets off a chain reaction throughout your body (MedlinePlus). In the worst cases blood pressure drops, the heart weakens and septic shock follows, and organs such as the lungs, kidneys and liver can quickly fail (NIGMS).

NIGMS, citing the Centers for Disease Control and Prevention (CDC), says at least 1.7 million adults in the United States develop sepsis each year and at least 350,000 die as a result. Sepsis is a leading cause of death in hospitals and a main reason people are readmitted (NIGMS).

What causes sepsis

Bacterial infections cause most cases (MedlinePlus) (NIGMS). Viral infections such as COVID-19 or flu, fungal infections, and injuries that are not infections, such as severe trauma, can also cause it (NIGMS). The infections that lead to sepsis are often in the lungs, stomach, kidneys or bladder. Sepsis can start with a small cut that gets infected or with an infection after surgery, and some people did not know they had an infection (MedlinePlus). The CDC lists sepsis as a rare complication of C. diff infection, a gut infection that most often follows antibiotic use (CDC).

See pneumonia risk factors, UTI risk factors and flu high-risk groups for some of the infections behind it.

Who is more likely to get sepsis

Anyone with an infection could get sepsis, but MedlinePlus says these people are more likely to develop it (MedlinePlus):

• Adults 65 or older
• Children younger than one
• People with chronic (long-lasting) conditions, such as diabetes, lung disease, cancer and kidney disease
• People with weakened immune systems
• Pregnant women

NIGMS names the people at highest risk as infants, children, older adults, and vulnerable people who have underlying medical problems, have injuries or surgeries at the same time, or take certain medicines. It adds that unknown biological traits may raise or lower a person's chance of sepsis and help explain why some people get worse faster than others (NIGMS).

Outcomes are not equal either: NIGMS notes that African American/Black and Latino patients with sepsis receive lower quality care and have higher rates of complications and death than non-Hispanic White patients (NIGMS).

Warning signs

Sepsis can cause one or more of these symptoms (MedlinePlus):

• fast breathing and fast heart rate
• shortness of breath
• confusion or disorientation
• extreme pain or discomfort
• fever, shivering or feeling very cold
• clammy or sweaty skin

Many of these signs can also come from other conditions, which can make sepsis hard to diagnose early. A clinician takes a history, checks vital signs (temperature, blood pressure, heart rate and breathing), and usually orders lab tests for signs of infection or organ damage, sometimes with an x-ray or CT scan to find the infection (MedlinePlus).

Treatment and what can follow

Treatment needs to start right away. It usually includes antibiotics, oxygen and intravenous (IV) fluids to keep blood flowing to the organs, treating the source of the infection, and if needed medicines to raise blood pressure. Serious cases may need kidney dialysis, a breathing tube, or surgery to remove damaged tissue (MedlinePlus).

Severe sepsis can lead to septic shock, when blood pressure drops to a dangerous level and several organs can fail (MedlinePlus). After recovery, some survivors have a weakened immune system that leaves them open to new infections, and sepsis can also leave lung injury, muscle wasting, problems with thinking and memory, and poor blood cell production (NIGMS).

Lowering the risk

Preventing sepsis means preventing infections. MedlinePlus suggests you (MedlinePlus):

• take good care of any chronic health conditions
• get recommended vaccines
• practice good hygiene, such as handwashing
• keep cuts clean and covered until they heal

Cellulitis is a common bacterial infection of the deeper layers of the skin, and if untreated it can spread and cause serious health problems (CDC). See cellulitis risk factors.

Common questions

Can sepsis happen in newborns and babies?

Yes. MedlinePlus lists children younger than one among the people more likely to develop sepsis, and NIGMS names infants and children among those at highest risk (MedlinePlus) (NIGMS). A baby with signs of infection needs prompt medical care.

Is pregnancy a risk factor for sepsis?

MedlinePlus lists pregnant women among the people more likely to develop sepsis (MedlinePlus). Talk to your clinician or maternity team quickly about a fever or signs of infection during pregnancy.

Which risk factors can I change?

Age cannot be changed. Keeping chronic conditions such as diabetes under control, getting recommended vaccines, washing your hands and caring for cuts all lower the chance of the infections that lead to sepsis (MedlinePlus). Do not stop a medicine without talking to your clinician.

Is there a sepsis score?

Clinicians use bedside scores such as qSOFA. Our qSOFA calculator is written for healthcare professionals, with its own sources and limits; it is not a way to rule sepsis in or out at home.