Hospitals are continuing in their struggle to identify sepsis early enough for effective treatment. The reasons are numerous: there’s no single test for the condition; diagnosis demands complex clinical judgment; and experts disagree about the right combination of clinical information that should spark implementation of sepsis treatment bundles.
Countries around the world are struggling with a unified framework to improve early sepsis identification and effective care. But throwing up our hands is not an option.
Consider these statistics:
- Sepsis is estimated to affect more than 30 million people worldwide every year, potentially leading to 6 million deaths, according the World Health Organization.
- The mortality rate among patients diagnosed and hospitalized with severe sepsis or septic shock is more than eight times higher than the mortality rate for any other diagnosis.
- Mortality rates increase by 7 to 10% for every hour of delayed treatment.
- Hospitals get reimbursed roughly half to two-thirds of the actual cost of treatment by Medicare.
- An effective approach to sepsis detection and treatment could save the typical 300-bed hospital about $2 million annually, a five-hospital system $5 million annually, and a regional system approximately $7.5 million annually in the US alone.
Hospital systems, however, are frustrated because at the moment, early detection tends to feel like a false, either/or choice between using the older, systemic inflammatory response syndrome (SIRS) criteria or the newer, sequential organ failure assessment (SOFA) criteria. Both of them are flawed.
SIRS criteria are extremely sensitive, capturing nearly all possible sepsis cases—but they generate an inordinate number of false-positives, which leads to alert fatigue and, at times, to clinicians’ ignoring early symptoms. SOFA criteria are more specific, but many of its indicators don’t occur until later in the illness, which results in more missed cases or delayed bundle implementation. And now, the Surviving Sepsis Campaign has begun recommending that hospitals initiate sepsis treatment bundles within one hour of the first signs of sepsis.