Sepsis begins outside of hospital in 80% of cases

The CDC today classified sepsis as a preventable medical emergency and said it begins outside of the hospital in 80% of cases.

A CDC evaluation also showed that 70% of sepsis patients had recently interacted with a health care provider or had a chronic disease that required frequent medical care.

“In other words,” CDC Director Thomas R. Frieden, MD, MPH, said during a telebriefing, “health care providers are on the front lines of both sepsis prevention and early recognition. Prevention really is possible.”

Thomas R. Frieden

Sepsis occurs when the body overreacts to an infection. Common signs include shivering, fever, extreme pain or discomfort, clammy or sweaty skin, confusion or disorientation, shortness of breath and an elevated heart rate.

Frieden called sepsis “an unrecognized killer” and said it has a mortality rate of between 15% and 30% in the 1 million to 3 million patients who are diagnosed with it each year. While the mortality rate has declined, cases of sepsis have increased, partly because of changing definitions about what it is.

“We know that however much there is, it’s too much,” Frieden said.

The CDC said health care providers should prevent infections and educate patients and their families to improve early identification of sepsis. Knowing the signs and symptoms of sepsis and acting fast by ordering tests and starting antibiotics are other steps health care providers can take.

“The recognition and treatment of sepsis is a race against time, and we can protect more people against sepsis by informing patients and their families, treating patients promptly and acting fast when sepsis does occur,” Frieden said.

According to the CDC report, lung infections such as pneumonia are associated with sepsis 35% of the time. It is also commonly associated with infections of the urinary tract (25%), skin (11%) and gut (11%). Common germs causing sepsis include Staphylococcus aureus, Escherichia coli and some types of Streptococcus.

Patients aged 65 years or older, or those aged younger than 1 year, who have weakened immune systems or a chronic medical condition such as diabetes are more at risk for sepsis, although it also can occur in healthy individuals.

“I think we can make tremendous progress in improving sepsis early recognition and care, but it is going to take a partnership between health care providers and the public working together to be vigilant, identifying sepsis early and treating sepsis appropriately,” Mitchell M. Levy, MD, MCCM, chief of the division of critical care, pulmonary, and sleep medicine at the Warren Alpert Medical School of Brown University and founding member of the Surviving Sepsis Campaign, said during the telebriefing.

Frieden recounted a personal experience with sepsis that happened more than 2 decades ago when he discovered his son, aged 4 months, pale and near death with bacteria in his blood.

Although rapid recognition led to the boy’s full recovery, “he could have died,” Frieden said.

“And far too many people die from sepsis today,” he said. – by Gerard Gallagher

Reference: CDC. Making health care safer — Think sepsis. Time matters. 2016. https://www.cdc.gov/vitalsigns/sepsis/index.html. Accessed Aug. 23, 2016.

Disclosure: The researchers report no relevant financial disclosures.

The CDC today classified sepsis as a preventable medical emergency and said it begins outside of the hospital in 80% of cases.

A CDC evaluation also showed that 70% of sepsis patients had recently interacted with a health care provider or had a chronic disease that required frequent medical care.

“In other words,” CDC Director Thomas R. Frieden, MD, MPH, said during a telebriefing, “health care providers are on the front lines of both sepsis prevention and early recognition. Prevention really is possible.”

Thomas R. Frieden

Sepsis occurs when the body overreacts to an infection. Common signs include shivering, fever, extreme pain or discomfort, clammy or sweaty skin, confusion or disorientation, shortness of breath and an elevated heart rate.

Frieden called sepsis “an unrecognized killer” and said it has a mortality rate of between 15% and 30% in the 1 million to 3 million patients who are diagnosed with it each year. While the mortality rate has declined, cases of sepsis have increased, partly because of changing definitions about what it is.

“We know that however much there is, it’s too much,” Frieden said.

The CDC said health care providers should prevent infections and educate patients and their families to improve early identification of sepsis. Knowing the signs and symptoms of sepsis and acting fast by ordering tests and starting antibiotics are other steps health care providers can take.

“The recognition and treatment of sepsis is a race against time, and we can protect more people against sepsis by informing patients and their families, treating patients promptly and acting fast when sepsis does occur,” Frieden said.

According to the CDC report, lung infections such as pneumonia are associated with sepsis 35% of the time. It is also commonly associated with infections of the urinary tract (25%), skin (11%) and gut (11%). Common germs causing sepsis include Staphylococcus aureus, Escherichia coli and some types of Streptococcus.

Patients aged 65 years or older, or those aged younger than 1 year, who have weakened immune systems or a chronic medical condition such as diabetes are more at risk for sepsis, although it also can occur in healthy individuals.

“I think we can make tremendous progress in improving sepsis early recognition and care, but it is going to take a partnership between health care providers and the public working together to be vigilant, identifying sepsis early and treating sepsis appropriately,” Mitchell M. Levy, MD, MCCM, chief of the division of critical care, pulmonary, and sleep medicine at the Warren Alpert Medical School of Brown University and founding member of the Surviving Sepsis Campaign, said during the telebriefing.

Frieden recounted a personal experience with sepsis that happened more than 2 decades ago when he discovered his son, aged 4 months, pale and near death with bacteria in his blood.

Although rapid recognition led to the boy’s full recovery, “he could have died,” Frieden said.

“And far too many people die from sepsis today,” he said. – by Gerard Gallagher

Reference: CDC. Making health care safer — Think sepsis. Time matters. 2016. https://www.cdc.gov/vitalsigns/sepsis/index.html. Accessed Aug. 23, 2016.

Disclosure: The researchers report no relevant financial disclosures.