When you are admitted to the hospital, you expect to be safe, to be taken care of, and to heal from whatever put you there in the first place. Unfortunately, despite the best efforts of their staff, hospitals can often be breeding grounds for germs, viruses, and harmful bacteria that leave many immuno-suppressed patients vulnerable to infection.
The sad reality is that instead of getting healthier, some patients who are admitted to the hospital end up contracting a virus or infection during their stay, which can often be life-threatening. Recently, doctors have come to the realization that sepsis, the most common cause of death in hospital patients in the United States, is killing twice as many people worldwide as once thought. 2017 data reported 48.9 million cases of sepsis and 11 million sepsis deaths worldwide- that means one out of every five deaths that year were caused by sepsis .
What is Sepsis?
Sepsis is caused by an overwhelming immune response to an infection.
When you contract an infection, your body’s normal response is to release immune chemicals into your bloodstream to combat it. Sepsis occurs when the body’s response to these chemicals is out of balance, which triggers inflammation throughout your entire body. Widespread inflammation causes your blood to clot and your blood vessels to leak. This impairs blood flow, depriving your organs of nutrients and oxygen and causing organ damage [2,3].
What Causes Sepsis?
Bacteria, fungi, and viruses can all cause sepsis, but most often it is a result of a bacterial infection. This infection commonly starts in the lungs, stomach, kidneys, or bladder, but can sometimes begin from a small cut that gets infected, or an infection that starts after surgery .
On some occasions, sepsis can happen in individuals who didn’t even know they had an infection .
It can be difficult to diagnose sepsis, because the symptoms – fever, chills, rapid breathing and heart rate, confusion, disorientation – are similar to many other conditions. What’s more, it cannot always be detected in the bloodstream, so doctors have to rely on these other symptoms to diagnose it .
Who is at Risk?
85 percent of cases in 2017 occurred in low and middle-income countries, predominantly sub-Saharan Africa, the South Pacific Islands near Australia, and South, East, and Southeast Asia .
Sepsis was more prevalent among females than males, and more than forty percent of cases were in children less than five years old .
Older adults, pregnant women, and children under the age of one are all at greater risk because their immune systems tend to be weaker. Anyone with a compromised immune system, such as those with AIDS, people who are on a long-term antibiotic, or people with cancer, are also at a greater risk, which is why sepsis is so prevalent in hospitals. Patients with chronic conditions, like diabetes, or kidney or lung disease are more likely to have experience sepsis [3,4].
A Burden on the Healthcare System
Every year, at least 1.7 million Americans develop sepsis, and nearly 270 thousand of them die as a result. That means that one out of every three hospital deaths in the United States is caused by sepsis .
This fatal medical condition has overburdened the American healthcare system and has been worsening over the last thirty years. The cost of treating sepsis patients is high, even higher than those hospitalized for heart attacks. This cost includes not only the expense of initial hospitalization but also the post-discharge care costs, which include post-sepsis syndrome and the cognitive and functional disabilities that follow. These complications often require a significant amount of long-term healthcare resources .
For these reasons, septicemia is the fourth most costly condition in the hospital, despite the fact that it is entirely preventable .
Dr. Mohsen Naghavi, a professor of health metrics sciences at the University of Washington School of Medicine in Seattle, finds this statistic both highly concerning and frustrating.
“We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable,” he said .
How Can Sepsis Be Prevented?
Dr. Naghavi wants to see a stronger focus placed on sepsis prevention in newborn babies, and on addressing antimicrobial resistance, which is a significant factor in the condition .
Dr. Kristina Rudd, assistant professor of critical care medicine at the University of Pittsburgh, is stressing the need for basic public health strategies.
“Vaccines, making sure everyone has access to a toilet and clean drinking water, adequate nutrition for children and maternal health care would address a lot of these cases,” she said .
At the individual level, there are a few steps you can take to prevent sepsis in yourself:
- Prevent infections. Since infection is how sepsis starts, this is your first line of defense in preventing it. Make sure you take good care of any chronic conditions if you have them, and always stay up-to-date on all your vaccines .
- Be clean. Practicing good hygiene, such as washing your hands and keeping cuts clean and covered until healed, will prevent the spread of bacteria .
- Be aware of the signs and symptoms. These include a high heart rate, fever, chills, or being very cold, confusion or disorientation, shortness of breath, extreme pain or discomfort, and clammy or sweaty skin .
- Act quickly. If you have an infection that is not getting better or is getting worse, or if you suspect that you may have sepsis, get medical care immediately .
Sepsis is an all-too-common health problem that is preventable. It is up to both the individual and the healthcare system to take appropriate action to prevent this alarming trend from continuing to worsen.