Are you at risk? Sepsis could affect hospital patients

By Glenn Ellis

The number of people who suffer from a potentially life-threatening type of inflammatory syndrome that affects the entire body — called sepsis — has grown by an average of nearly 9 percent each year over the past 22 years. A new study shows more people are dying from this rapidly progressing syndrome despite advances in treatment.

Sepsis, a usually fatal medical condition caused by the body’s response to a severe infection of the blood and/or tissues, affects 5 to 10 percent of all hospital patients, leading to an increase of about $5 billion in U.S. health-care costs annually.

Sepsis can be deadly — the condition is fatal in up to 30 percent of cases. While some patients develop sepsis while in the hospital, a new report out from the Centers for Disease Control and Prevention in Atlanta says 80 percent of cases are acquired outside of the hospital.

A CDC evaluation found more than 90 percent of adults and 70 percent of children who developed sepsis had a health condition that may have put them at risk.

Sepsis cases in the U.S. nearly doubled from 2000 to 2010, the CDC reported. Of the million or so Americans each year who get sepsis, roughly 300,000 die. Deaths from sepsis are on the rise due to growing antibiotic resistance which means previously harmless infections can become fatal.

Cases of sepsis acquired while in the hospital are usually associated with a bacterial infection, such as pneumonia or appendicitis. But the CDC’s report says that, in 70 percent of cases, sepsis develops in a patient who recently visited his or her healthcare provider and/or had a chronic medical condition, such as diabetes.

Sepsis develops when an infection gets into the bloodstream and affects the whole body, triggering a violent and potentially fatal immune response which can cause organ failure. Sepsis begins when an infection activates a person’s entire immune system, which then sets off a chain reaction of events that can lead to uncontrolled inflammation in the body. This whole-body response to infection produces changes in temperature, blood pressure, heart rate, white blood cell count, and lung function. More severe forms of sepsis can also cause organ dysfunction or shock.

Common symptoms of sepsis are fever, chills, rapid breathing and heart rate, rash, confusion and disorientation. Many of these symptoms, such as fever and difficulty breathing, mimic other conditions, making sepsis hard to diagnose in its early stages.

Infections most commonly associated with sepsis involve the respiratory, digestive, or urinary tracts or the skin. In hospitalized patients, the condition often begins with an infection that originates around an IV or surgical wound or drain, or in an area where the skin has broken down — bed sores, for example.

Doctors diagnose sepsis by examining patients for fever, increased heart rate and increased respiratory rate. They often perform a blood test to see if a patient has an abnormal number of white blood cells, a common sign of sepsis; or an elevated lactate level, which correlates with severity of the condition. Doctors may also test blood and other bodily fluids such as urine and sputum for the presence of infectious agents.

Unfortunately, many treatments for the condition have looked promising in small, preliminary studies, only to fail in follow-up research.

Sepsis should be treated as a medical emergency. In other words, sepsis should be treated as quickly and efficiently as possible as soon as it has been identified. This means rapid administration of antibiotics and fluids.

Antibiotics (usually more than one type) are prescribed by the physician based on the type of infection that is causing the illness. The first antibiotics are usually broad-spectrum, which means the antibiotic is effective against several of the more common bacteria. The antibiotics are given by intravenous in order to ensure they get into the blood system quickly and efficiently.

Antibiotics alone won’t treat sepsis; fluids are also needed. Ensuring the body has enough fluids helps the organs do their work and may reduce damage from sepsis.

Adults over age 65 are three times more likely than younger patients to develop sepsis within three months of being discharged from the hospital, according to a study published in the American Journal of Respiratory and Critical Care Medicine in May 2015. Babies under the age of one and people with a weakened immune system are also at increased risk.

Many people who survive severe sepsis recover completely and their lives return to normal. But some people, especially those who had pre-existing chronic diseases, may experience permanent organ damage. For example, in someone who already has kidney impairment, sepsis can lead to kidney failure that requires lifelong dialysis.

There is also some evidence that an episode of severe sepsis disrupts a person’s immune system, making him or her more vulnerable to future infections.

If you have a chronic medical condition, ask your doctor about steps you can take to reduce your risk of infections, such as controlling blood sugar for persons with diabetes.

Ask your doctor about your risk for getting sepsis. If you suspect sepsis, ask your doctor, “could it be sepsis?”

Remember, I’m not a doctor. I just sound like one.
Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.
 
Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. For more good health information, visit: www.glennellis.com