Mortality rates among adults with sepsis and septic shock in Indonesia: a systematic review and meta-analysis

INTRODUCTION: Sepsis and septic shock represent a critical global health challenge, accounting for a substantial proportion of patient fatalities worldwide. Despite this, Indonesia lacks a comprehensive, nationwide analysis of the mortality rates associated with these conditions. This study aimed to systematically evaluate the burden of sepsis and septic shock mortality across Indonesia, addressing a crucial gap in the existing healthcare data, which may aid clinical and policy considerations. METHODOLOGY: We searched PubMed, Scopus, DOAJ, and citation lists for studies with sepsis and septic shock mortality rate , focusing on 28-day and in-hospital mortality. Study quality was assessed using the Newcastle-Ottawa Scale, and the protocol was registered with PROSPERO (CRD42025645312). RESULTS: Overall, 47 studies were included in this review , revealing a pooled 28-day mortality rate of 55.9% (95% CI, 48.7%-63.0%; I2 = 79.5%) among patients with sepsis and septic shock, as determined by the Sepsis-3, Sepsis 2, and Not-Mentioned criteria. Additionally, the in-hospital mortality rates for the same cohort were higher at 67.4% (95% CI, 62.9%-72.0%; I2 = 95.02%). Notably, among patients with septic shock specifically, in-hospital mortality reached 77.5% (95% CI, 67.3%-87.8%; I2 = 91.18%). CONCLUSIONS: Sepsis and septic shock mortality rates in Indonesian adults remain high. These findings underscore the need for enhanced sepsis management protocols, effective resource allocation, and targeted interventions for vulnerable patients.