Sepsis is one of the leading causes of death in Intensive Care Units (ICU)
What is sepsis?
Sepsis is a life-threatening illness caused by the immune system’s response to an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection and modulate the patient’s response trigger a generalized inflammation throughout the body. It is thought that the inflammation creates microscopic blood clots that can prevent nutrients and oxygen from reaching organs, causing them to fail.
Severe sepsis can rapidly deteriorate to septic shock, often leading to organ failure and death. Most people recover from mild sepsis, but the mortality rate for severe sepsis or septic shock is nearly 50%.
Why are improved diagnostic and monitoring methods needed?
Better clinical outcomes are achieved when treatment is begun as soon as possible after diagnosis. Currently, the most common approach for diagnosing sepsis is slow (microbial culture >24 hours) and insensitive (fails to accurately diagnose 30 to 50% of sepsis cases), and treatment is insufficiently targeted and timed.
Sepsis is also a significant burden on overall healthcare costs around the globe. In the U.S. alone, sepsis-related healthcare costs exceed $17 billion per year. The cost of treating septic patients in an ICU can add $5,000 or more per day to a patient’s bill, with treatment lasting at least two days and often more than 20 days. Additionally, nearly 50 percent of diagnosed sepsis cases in the US are attributable to hospital-acquired infections (HAIs), which impose a major direct cost on hospitals due to little to no reimbursement from health insurers. New technologies to allow earlier detection and personalized management of patients with, or at risk of, sepsis could significantly reduce the financial burden on healthcare systems worldwide through:
• Reduced patient mortality;
• Fewer missed cases in Emergency (which invariably lead to litigation);
• Reduced stays in ICU;
• More targeted use of antibiotics and anti-inflammatories;
• Reduced antimicrobial resistance; and
• Reduced at-risk admissions.
Facts About Sepsis
Patients at risk include infants, mothers after childbirth, the elderly, those with weakened immune systems or those who have experienced significant trauma/injury, invasive surgery, or burns. However, healthy people can also develop and become ill from sepsis.
Sepsis is complex, dynamic, and poorly understood. It is not only difficult to diagnose early, but also difficult to determine the level of severity and to distinguish it from Systemic Inflammatory Response Syndrome, or SIRS – an inflammatory state affecting the whole body that presents very much like sepsis, but is not caused by infection.
• 30% of the ICU patient admissions are trauma/injury related; these patients are usually admitted with SIRS and are at high risk of developing sepsis.
• Severe sepsis accounts for 20% of all ICU admissions in the U.S.
• Patients are more likely to die from sepsis following surgery than pulmonary embolism.
Patients with SIRS are 2.2 times more likely to develop sepsis than those without SIRS. Fifty to 90% of patients in ICUs have an undifferentiated SIRS.
Sepsis is usually treated in a hospital ICU. Patients with sepsis are treated with IV broad-spectrum antibiotics (which begins immediately once sepsis is suspected) to control the infection and fluids to keep blood pressure from dropping too low. Patients with sepsis may also need respirators to help them breathe.
Globally, there are 18 million cases of diagnosed sepsis per year and the incidence is rising at 8 to 10% annually, in line with an ageing population in the developed world and an increase in patients with compromised immune systems (e.g. diabetics, patients with cancer receiving treatment with chemotherapy, patients with AIDS, or patients who have received a transplant).
In the U.S. alone, there are more diagnosed cases of severe sepsis each year than colon cancer, breast cancer, AIDS, and congestive heart failure combined.
Worldwide, 1,400 patients die from sepsis each day and in the developed world, 511,000 die from diagnosed sepsis each year. Severe sepsis causes more deaths per year (~250,000) in the U.S. than acute myocardial infarction.
* These data do not take into account misdiagnosis or the under reporting of sepsis.