Sepsis: Fighting a Deadly Intruder

By: Sue Carrington

It’s a shocking statistic. Worldwide, every 3.5 seconds, someone dies from sepsis. This fast-moving medical complication sets in when the body tries to fend off an infection but attacks instead its own tissues and organs. Today, sepsis is the leading cause of death in U.S. hospitals and the tenth-leading cause of death throughout the country.

 

Determining the risk

 

“Patients at the greatest risk of developing sepsis are those who have been recently hospitalized or treated for an infection, have a weakened immune system due to their diseases or medications, have indwelling catheters, have unhealed wounds, or are bedridden,” says Minaxi Rathod, MD, an infectious disease specialist in Sherman, Texas. Dr. Rathod serves also as a consultant to StoneGate Senior Living, a leading provider of rehabilitation, skilled nursing, assisted living, and memory care services.

“We see sepsis most often in the elderly, whose immune systems are increasingly compromised as they are living with multiple chronic diseases, such as cancer, diabetes, and heart conditions. Infants and young children are also highly vulnerable, as their immune systems may not have developed enough to fight infection.

“A study from the U.S. Centers for Disease Control and Prevention (CDC) found that seven in 10 patients with sepsis had recently used healthcare services or were living with chronic diseases that require frequent medical care.”

 

Diagnosing the rising rates of sepsis

 

Sepsis was first defined in the 19th century. In recent years, its incidence has surged, with cases tripling in the nine-year span of 2005 to 2014. According to the CDC, each year in the U.S., more than 1.5 million people contract sepsis and at least 250,000 die from it. One in three patients who die in the hospital have sepsis.

Dr. Rathod highlights several key reasons for the spike in sepsis cases. “Patients are living longer, thanks to better medicine and progressive technology. The older we are, the more we’re at risk of developing sepsis. As technology has improved, we have many more invasive medical devices and procedures that can cause infections, from pacemakers to reconstructive joints and organ transplants. Advances in cancer treatment have produced strong chemotherapy drugs that can destroy cancer cells but also lower cancer patients’ ability to stave off infection—increasing their susceptibility to sepsis.”

 

Detecting the symptoms

 

Sepsis can present with several symptoms but can also appear to be a less serious ailment and may be difficult to pinpoint initially. No single test can diagnose sepsis.

“The patient may have a fever or chills, confusion, low blood pressure, and rapid heart and breathing rates,” Dr. Rathod says. “The clinical team must evaluate all symptoms and indicators and—if sepsis is suspected—move the patient to the hospital intensive care unit for immediate intervention.

“The challenge is to recognize an invasive infection before it leads to severe sepsis, resulting in clotting of the blood vessels, drops in blood pressure, a weakened heart, and failure of one or more organs—leading to septic shock and often death,” she notes.

 

Delivering timely treatment

 

Delivering timely treatment and supporting the organs with ventilators, fluids, antibiotics, and constant vigilance may prevent this downward spiral. A study finds that for patients with sepsis, every hour’s delay in giving antibiotics decreases survival rates by 7.6 percent.

Many hospitals have implemented protocols, checklists, and algorithms to help detect sepsis and intervene before it progresses to the severe stage. “The goal of the clinical care team is to  prevent a drop in blood pressure, treat the infection, and sustain vital organs,” Dr. Rathod explains. “Patients are treated with antibiotics, oxygen, and intravenous fluids. Some may require respirators or kidney dialysis. If the infection persists, surgery may be needed to drain the infection.”

 

Developing a plan for post-acute care  

 

For patients who survive severe sepsis, hospital readmission is common: 42 percent of those who are hospitalized with the condition are readmitted within the next three months. To avoid readmissions that impede recovery and drive up costs, post-acute care (PAC) providers have intensified efforts to closely monitor patients who have suffered from sepsis.

Leading PAC facilities are training staff to rapidly identify patients who may be susceptible. For example, Dr. Rathod has launched a program to help one of StoneGate’s Texas-based PAC communities, the Homestead of Sherman, in educating nurses on infection control, implementing best practices for sepsis and wound care, and practicing “antimicrobial stewardship”—activities that help promote the appropriate dose, type, and duration of antibiotics.

The best chance for treating sepsis is to catch it early. “Our focus is on increasing awareness of sepsis signs and symptoms so care teams are quicker to spot and treat them,” she says. “Through proactive education and evidence-based protocols, PAC providers can reduce the incidence of sepsis in our healthcare system—improving patient outcomes, stemming the tide of unnecessary hospital admissions, and ultimately, winning the war on this lethal intruder.”

Research has found that patients who receive post-acute care after a major health episode such as sepsis improve faster with a coordinated care approach. To learn more about a collaborative and integrated care approach to address medically complex diseases, contact StoneGate Senior Living.

 

About the Author:

Sue Carrington is a seasoned and purpose-driven journalist, with a focus on healthcare innovation. She has pursued her love of words through a diverse array of callings – from book editor to radio news director, public relations manager to corporate writer and freelance writing entrepreneur. Sue is a native of the Washington, DC, area.