A Major Effort Needed to Fight Sepsis

By Sondra Forsyth

Sepsis – a blood infection that can lead to organ failure and death – is just as important a research subject as heart disease or pneumonia, according to health experts from the University of Michigan Medical School.

Although sepsis isn’t as well-known as heart disease, the experts say, it now affects more hospital patients, and leads to more hospital costs, than any other diagnosis. Half of all in-hospital deaths involve sepsis. One of every six cases is fatal.

In an article in the Journal of the American Medical Association, the researchers call for a national system to hold hospitals and health care teams responsible for sepsis diagnosis and care.
The federal government should also do what it’s done in the case of other disease: set clear standards and targets for the kind of care that gives the best chance of survival to sepsis patients. A new effort should reward better detection of sepsis and respond to rapidly growing sepsis research.

Right now, the authors say, only one-third of sepsis patients nationwide receive the best possible care. It’s common for sepsis to be diagnosed late or not at all.

“Now’s the time to focus on quality improvement in sepsis, because it has become one of the most important conditions in hospitals, it attacks more and more patients, and we can learn from the years of work in other conditions,” said study co-author Colin Cooke, M.D., M.Sc., M.S., a U-M critical care physician who authored the article. “We believe that by creating a framework for quality improvement in sepsis care that takes into account evolving knowledge of this condition, we can improve patients’ odds of survival and reduce variation in care.”

Cooke and co-author Theodore Iwashyna, M.D., Ph.D., said a major challenge with sepsis is to develop a single diagnostic tool.

“There is not just one magical test to detect sepsis,” says Iwashyna. “Excellent sepsis care requires careful clinical judgment and good teamwork, but at the same time it has to happen fast. This is not easy. But we have to improve our quality of care even when it is not easy.”

Cooke is an assistant professor, and Iwashyna an associate professor, in the Pulmonary & Critical Care Division of the U-M Department of Internal Medicine.