Sepsis: A Deadly and Costly Crisis

Sepsis is prevalent around the world and directly impacts population health. The World Health Organization (WHO) estimates that more than 30 million people every year are diagnosed with sepsis, resulting in 6 million deaths worldwide.1 In 2012, the Global Sepsis Alliance initiated World Sepsis Day (September 13) to raise awareness about sepsis around the world and to reduce sepsis-related deaths.

While the burden of sepsis is highest in low- and middle-income countries, sepsis does not discriminate across ethnicity, nationality, and color, playing an important role in morbidity and mortality around the globe. The incidence of sepsis is growing considerably and remains one of the deadliest and most expensive conditions.

 

What is sepsis?

Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death. Treatment and complications arising from sepsis can result in extended hospital length of stay and readmissions and as such has a tremendous financial impact on healthcare. In fact, sepsis patients cost 6 times more to treat than non-sepsis patients. Over the last decade, hospital admissions due to sepsis have doubled and inpatient hospital death rates have increased by 17%.2 Despite established evidence-based guidelines, the mortality rate for septic shock is
still 40-70%.2

Sepsis at a glance
  • Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death.
  • The World Health Organization (WHO) estimates that more than 30 million people every year are diagnosed with sepsis, resulting in 6 million deaths worldwide.1

While onset and severity are closely related to a patient’s risk status, including not just advanced age, but newborns, those with underlying infectious diseases like HIV/AIDS, liver diseases, cancer, and autoimmune disorders, anyone regardless of health status can develop sepsis. Early signs can be subtle and hard to detect, especially in unsuspecting patient populations such as young adults, further compounding the complexity of sepsis management.

Patients with symptoms related to sepsis frequently present in the emergency department (ED) as urgent cases. Patients are likely to be treated in critical areas of the hospital including the ICU, CCU, and Surgical ICU. In fact, sepsis is a common diagnosis among those admitted to the ICU.3 In ICU patient populations, it may also be difficult to diagnose sepsis quickly because symptoms may resemble complications from other underlying diseases or conditions.

 

Creating awareness

Public awareness of sepsis varies by country, but is low globally. In Germany – the home of the Global Sepsis Alliance and World Sepsis Day – approximately half (49%) of a surveyed population has heard of sepsis. And, in the US, only 40% of the public has heard of sepsis. In contrast, in Brazil, that number was 6.6%.4 

 

Sepsis patients cost 6 times more to treat than non-sepsis patients.

Solving the problem

Regardless of this low awareness, as a medical emergency, the ability to quickly diagnose and treat sepsis remains the best way to reduce mortality and severity of long-term complications, such as chronic pain, fatigue, organ dysfunction, and limited mobility. Speed is key, with evidence showing that for every hour that sepsis treatment is delayed, the risk of death increases by 8%.5

Point of care lactate testing, which offers providers the ability to immediately test patient samples at the bedside, can help accelerate risk stratification of patients diagnosed with sepsis.6 With this added insight, patients at risk of higher mortality, including those with septic shock, can be identified sooner and immediate resources and care can be directed to those that need it most.

In the last several years, there has been a great deal of focus on targeted programs to reduce sepsis. In 2018, the Surviving Sepsis Campaign Bundle was updated to combine the 3 hour and 6 hour bundles into a single “hour-1 bundle,” which includes the measurement of lactate.7 Several other organizations have created sepsis “bundles” and sets of evidence-based practices as well, including the World Health Assembly, the Institute for Healthcare Improvement and the National Quality Forum.

For every hour that sepsis treatment is delayed, the risk of death increases by 8%.5,6

References

1. World Health Organization. Sepsis Fact Sheet.
2. The Advisory Board Company. Ten Imperatives to Reduce Sepsis Mortality 2013.
3. Genga KR, Russell JA. Update of Sepsis in the Intensive Care Unit. J Innate Immun. 2017;9(5):441-455.
4. Simon Finfer, Flavia R. Machado. The Global Epidemiology of Sepsis. Does It Matter That We Know So Little? AJRCCM Issues. Vol. 193, No. 3 | Feb 01, 2016. 
5. Sepsis Alliance.  Sepsis Fact Sheet. 
6. Shirey, Terry L. PhD. POC Lactate: A Marker for Diagnosis, Prognosis, and Guiding Therapy in the Critically Ill. Point of Care: The Journal of Near-Patient Testing & Technology: September 2007 -
Volume 6 - Issue 3 - p 192-200.  
7. Surviving Sepsis Campaign.  www.survivingsepsis.org. 

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