Sepsis – So Deadly, So Under Recognized
I work with a US-based group, Sepsis Alliance (SA). It’s a patient advocacy group with a mission to raise sepsis awareness and save lives. While it’s an American organization, the situation in the US parallels that of Canada when it comes to sepsis recognition and management. According to a report issued by Stats Canada in 2011, one in every 18 deaths in Canada is due to sepsis—one out of every 18. In the US, it kills over a quarter of a million people every year. That is a lot of deaths. Why is this happening?
Sepsis isn’t always preventable, this is true, but early detection and treatment often prevents it from progressing to severe sepsis and septic shock. A couple of years ago, I saw how effective a sepsis protocol can be. A family member who had a stroke was diagnosed with endocarditis while in the ICU. He showed the classic signs of sepsis onset and the staff was all over it, preventing more complications. Research has shown that for every hour patients with severe sepsis aren’t treated, their chance of survival drops by 8%. Like stroke and myocardial infarctions, there is a “golden hour,” during which immediate treatment can mean the difference between life and death.
I’ve learned a lot about sepsis and its impact over the past seven years, working with SA. One of my tasks is to respond to emails from people who want to share their stories of sepsis, hoping to spread the word to spare someone else the same pain. The stories, which are published on the site, are heartbreaking: parents who lost children, children who lost parents or siblings, survivors who live with life-changing effects caused by sepsis. So many of these victims may not have been in that situation if they or someone else had recognized the signs and symptoms of the condition.
Jim O’Brien, MD, former medical director of SA, often says that we could—right now—cut the sepsis death rate in half even without new technology, new tests, or new medications, simply with early recognition and immediate treatment with antibiotics and fluids. But there lies the rub –sepsis has to be recognized in time for successful treatment. People need to know about it and how to recognize it.
According to annual surveys commissioned by SA, most people have never heard the word “sepsis,” and many of those who have, don’t know what it means. The medical community is partly responsible for this. We talk about people dying of complications of pneumonia, of urinary tract infections, or meningitis. But that’s not that they died of; they died from sepsis. If someone has cancer, develops an infection and dies, it’s not the cancer that killed, them, it’s sepsis. But we don’t say that.