Sepsis: A Deadly and Frighteningly Common Problem
You might know the older phrase, “blood poisoning,” for the deadly medical complication that is known these days as sepsis. Sepsis is often related to a hospital stay: Only one-tenth of patients are admitted with sepsis, but it contributes to up to half of all hospital deaths.
In a study based on data from 6.5 million hospital discharge records, researchers discovered that the rate of deaths in hospitals among sepsis patients was 10.4 percent, as opposed to a rate of 1.1 percent among patients without sepsis. According to the Centers for Disease Control and Prevention (CDC), sepsis affects nearly 750,000 hospitalized U.S. patients annually, killing over 258,000.
Sepsis is most common in children, the elderly, those with compromised immune systems, and those with chronic illnesses, but it can be fatal to anyone. In March, 2012, a 12-year-old boy from Queens, NY, scraped his elbow playing basketball. The wound was not cleaned, and a few days later, he died in an ICU from sepsis.
It is a growing problem for all of us.
Sepsis and Septic Shock Defined
When a localized infection, arising from a urinary tract infection, pneumonia, a surgical procedure, or even a bedsore, gets into the bloodstream, it then spreads throughout the body, arousing the body’s immune system. The immune system’s extreme, life-threatening response to the infection that is carried through the bloodstream is known as sepsis. It can mean tissue damage and loss, organ failure, and death.
Septic shock is a severe form of sepsis characterized by abnormally low blood pressure that cannot be raised by either drugs or the use of fluids to increase blood volume (and therefore blood pressure). Patients who enter into septic shock have a much higher mortality rate (about 40 to 60 percent) as opposed to patients with sepsis who show no signs of organ failure (about 15 to 30 percent).
Causes of Sepsis
Saying that a local infection can result in sepsis is too generalized a statement, because sepsis often has its roots in certain kinds of infections and situations:
- Community-acquired pneumonia
- Hospital-acquired pneumonia
- Urinary tract infections, especially from catheters
- Surgical and other medical procedures.
Many cases of sepsis can be traced to hospital-acquired infections or to procedures that occurred in the hospital. Sepsis can also arise from negligence in tending to wounds such as bedsores.
Symptoms of Sepsis
Sepsis can be characterized by a number of symptoms. A combination of at least two symptoms can indicate the disease:
- Body temperature either abnormally high or abnormally low
- Shortness of breath
- Increased rate of respiration
- Warm skin, sometimes with a rash
- Rapid heart beat
- Extreme weakness or fatigue
- High white blood cell count
- Abnormal platelet count
- Elevated blood sugar.
Because sepsis involves a systemic infection, other signs of infection (vomiting, diarrhea, sore throat, etc.) can also be present.
Sepsis is difficult to diagnose. There is no one definitive test for sepsis, and the symptoms can be mistaken for other medical conditions. If you or a loved one is hospitalized and you are concerned sepsis is present, make sure you voice your concerns to medical caregivers.
Treatments for Sepsis
In almost all cases, sepsis requires hospitalization to monitor blood pressure, treat the infection, and keep the vital organs working. The following treatments are commonly required, though not all of them may be needed by any one patient:
- Antibiotics delivered by IV. It is important that testing be done so that the correct antibiotic is used. For example, sepsis arising from pneumonia caught outside the hospital might require cephalosporin; a hospital-acquired case might call for ceftriaxone.
- Fluids delivered by IV to maintain blood pressure.
- Medication to raise blood pressure.
- Machine-assisted breathing.
- Other organ-sustaining treatments such as kidney dialysis.
Sepsis is never easy to eradicate. A patient with sepsis, at the least, will undergo strong antibiotics administered by IV that have serious and unpleasant side effects. If the disease worsens, multiple antibiotics may be needed. Surgery may also be required to remove damaged tissue, including removal by amputation if the initial infection was in a limb. Death from septic shock and multiple organ failure is always a risk.
The sooner sepsis is diagnosed and treated, the greater the chance for a positive outcome: that is something all doctors agree on. Symptoms must be taken seriously and acted upon quickly, with the appropriate blood tests run and certain support procedures put in place—such as IV fluids and oxygen at a minimum—while waiting for confirmation from tests. Time is always of the essence when it comes to sepsis, but it is especially true if the infection is a hospital-acquired one, as happens with a significant number of sepsis cases.