The third leading cause of death in America is something you've probably never seen on the news.
Sepsis, or an infection of the blood, occurs when bacteria enter the bloodstream and spread throughout the body. The body unleashes an overwhelming immune response, but chemicals from the immune system create large-scale inflammation and leaky blood vessels.
The result is impaired blood flow throughout the body.
When the body goes into septic shock, leaky blood vessels cause the blood pressure to drop and weaken the pumping action of the heart. Organs begin to shut down because they're getting an inadequate supply of oxygen and nutrients.
When major organs like the lungs, liver and kidneys fail, patients are at great risk for death. In fact, 25 to 50 percent of patients with sepsis die from the condition, and it accounts for 17 percent of U.S. hospital deaths.
A new study from doctors at the University of Pennsylvania's Perelman School of Medicine, to be published in the journal Critical Care Medicine, finds that the disparities among definitions of sepsis impedes some hospital personnel from making an accurate early diagnosis.
In general, the medical community has four different protocols for identifying sepsis. The identification of sepsis varies according to the type of definition used. Definitions that are more inclusive tend to catch sepsis before it's too late.
The longer doctors wait to administer antibiotics and fluids to a patient, the more likely that the patient will die. Also, knowing the true number of deaths from sepsis is difficult when physicians don't use unified definitions to identify it as a cause of death.
The study's lead author, Brendan Carr, MD, MS, is an assistant professor of emergency medicine, surgery and epidemiology at the University of Pennsylvania. "Many hospitals are using a more proactive approach to identifying sepsis, by implementing alerts based on lab results, vital signs, and other data in an attempt to lower their sepsis mortality," Carr said.
"But for these efforts to be truly effective, a uniform definition of sepsis and a universal means by which to measure outcomes are essential."
Carr suggests pay-for-performance initiatives that will give hospitals incentives to lower their death rates from septic shock. Tying reimbursement to outcomes is a critical component of the Affordable Care Act.
However, the gateway for lowering sepsis deaths is the unification of diagnostic criteria. "As therapies for sepsis evolve, accurate and consistent estimates of sepsis incidence are critical for proper distribution of limited healthcare resources," said the study's lead author, David Galeski, MD, an associate professor of emergency medicine at the university.
Edited by
Braden Becker
