Incidence, mortality, and economic burden of sepsis in Switzerland, 2019-2023: A nationwide population-based analysis

Abstract

Objectives: To quantify national trends in sepsis incidence, mortality, healthcare utilisation, and direct hospital costs in Switzerland from 2019 to 2023 using routine hospital discharge data.

Methods: We conducted a nationwide retrospective analysis of all acute care hospitalisations in Switzerland (2019-23) using discharge data linked to mortality and cost records. Sepsis was identified using explicit and implicit ICD-10 coding. Outcomes included incidence, in-hospital, 30-, 180- and 360-day mortality, resource use and direct hospital costs.

Results: From 2019 to 2023, 99,579 admissions (1.6%) met explicit and 410,498 (6.5%) implicit sepsis definitions. Incidence and mortality were stable, with highest rates in neonates and older adults. In 2023, age- and sex-standardised incidence was 238 per 100,000 population for explicit and 963 per 100,000 for implicit sepsis; in-hospital mortality for explicit sepsis was 189 per 1000 admissions. Annual direct hospital costs rose to CHF 1.07 billion, averaging CHF 51,000 per case.

Conclusions: Sepsis represents a significant and underestimated burden in Switzerland, marked by high mortality and rising costs. Reliance on explicit coding underestimates this burden. Integrated surveillance and harmonised definitions are needed to capture the true impact and guide policy.

Keywords: Burden of disease; Health care costs; ICD-10 coding; Mortality; Sepsis epidemiology; Switzerland.