The Sepsis Epidemic

An estimated 750,000 Americans get sepsis each year—and 28 and 50 percent of these people will die from the infection.

What's more, the number of patients being treated for sepsis has increased at an increasingly staggering cost—$17 billion dollars a year—due to a prolonged hospital stay to treat the condition.

Sepsis is a potentially life-threatening illness. It occurs when inflammation from an infection creates blood clots that impair blood flow and deprive the organs of nutrients and oxygen, causing them to fail.

If left unchecked, severe sepsis can quickly progress to septic shock resulting in a dramatic drop in blood pressure and possibly death, adds Kathy McDowell, R.N., Clinical Quality Consultant at Decatur Memorial Hospital in Illinois.

The incidence of sepsis has been increasing each year. Experts believe the increase may be due to:

  • The aging population (nearly 60 percent of patients that develop severe sepsis are age 65 and older)
  • Weakened immune systems
  • Drug-resistant bacteria

The proliferation of drug-resistant bacteria is the result of overuse of antibiotics. It's important to keep in mind that antibiotics are effective only against bacterial infections. When an antibiotic is used for a viral infection, they are not effective and contribute to antibiotic resistance.

Also, when prescribed an antibiotic, it's important to take the full course as prescribed by your doctor. Taking the antibiotic for only a few days can result in the bacteria becoming more resistant, says McDowell.

Who's at Risk for Sepsis?

Sepsis can develop in anyone at any age. However, it is most common in:

  • Infants under 1 year old, and adults over 65. An infant's immune system is not developed enough to fight off an overwhelming infection, explains McDowell. And a decline in immune functions occurs naturally with aging.
  • People with chronic medical conditions, such as uncontrolled diabetes, cancer, kidney disease, alcohol abuse, and AIDS.
  • Patients affected by pneumonia, or infections in the abdomen, kidney, or bloodstream.
  • Patients undergoing medical treatments that weaken the immune system, such as chemo therapy and steroid therapy.
  • Most cases of sepsis occur in hospital patients, the majority of which are in the intensive care unit (ICU). Not only are ICU patients immuno-compromised, they're more likely to have intravenous catheters and breathing tubes inserted, which are potential sources for bacteria to enter the body, explains McDowell.

The Importance of Early Detection of Sepsis

Severe sepsis accounts for 20 percent of all admissions to the ICU and is the leading cause of death in non-cardiac ICUs. Studies show that if you wait for even four to eight hours to begin antibiotic therapy, the mortality from sepsis worsens considerably.

However, if detected early, sepsis is curable. Even if it has progressed to a severe status, detection (and subsequent treatment) can minimize organ damage and improve survival.

To treat sepsis, an evidence-based protocol has been developed called Early Goal-Directed Therapy (EGDT). According to McDowell, this is a grouping of interventions that are to be carried out within six hours of arrival to the hospital. They include prescribing broad-spectrum antibiotics, determining the source of infection, stabilizing respiratory status, restoring perfusion to the organs, and providing IV fluids. When treated early and aggressively the progression of sepsis can be slowed or stopped. Studies show that EGDT provides significant benefit in patients with severe sepsis and septic shock by decreasing cost and reducing risk of sepsis-related mortality by 46 percent.




Kathy McDowell, R.N., Clinical Quality Consultant at Decatur Memorial Hospital in Illinois

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