Hospitalizations for sepsis, or blood poisoning, more than doubled in the last decade, a new report shows.
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The condition, caused when bacteria from an infection in the skin, lungs abdomen or urinary tract seep into the blood stream, can rapidly become life-threatening, with almost 20 percent of patients dying at the hospital, researchers from the Centers for Disease Control and Prevention reported Tuesday.
Margaret Jean Hall, a health statistician at the CDC’s National Center for Health Statistics, said she was surprised by the jump in cases when “most hospitalizations for various conditions were going down at the same time.”
For the new report, Hall and her colleagues scrutinized hospital admission data in the United States from 2000 to 2008.
Most of the sepsis cases — two-thirds — were in people 65 and older, the researchers reported. And the rate skyrocketed as people aged: hospitalization for sepsis among people aged 85 and over was 30 times that of people under age 65. The seriousness of the condition is reflected in the amount of time patients spend in the hospital. Hall and her colleagues found that patients with sepsis spent 75 percent longer in the hospital than patients with other diagnoses.
Further, sepsis patients were more than eight times as likely to die at the hospital compared to patients with other diagnoses. The death rate among all patients hospitalized for sepsis was 17 percent. It was 20 percent among those 65 and over. And those who do survive can be left with debilitating after effects, such as organ damage, physical disability or cognitive impairment, Hall said.
The new data underscore the importance of immediately treating suspected blood infections with broad-spectrum antibiotics rather than waiting for a firm diagnosis, she added.
Hall and her colleagues couldn’t say for sure why the sepsis rate had jumped, but suggested possible explanations. The population of elderly people is growing — as people age they tend to have more chronic illnesses and are more likely to be using drugs that suppress the immune system. Also, Hall noted, there has been an increase in invasive procedures like surgery and the use of catheters that bring medications directly into the blood stream and there has been a rise in the number of drug-resistant bacteria.
Sepsis expert Dr. R. Phillip Dellinger agreed that the report should sound a wake-up call to medical personnel and patients. "We all need to be more aware of sepsis and physicians need to be more liberal with antibiotics whenever severe sepsis is suspected," he said.
Physicians are often loathe to give out antibiotics without a firm diagnosis based on blood tests because they fear that this could lead to more drug-resistant strains of bacteria, said Dellinger, director of critical care at Cooper University Hospital in Camden, N.J.
“But my personal bias is that you’re better off assuming it could be severe sepsis and starting antibiotics right away,” he added. “But you then have to be willing to stop them if you see that it is not sepsis.”
Time is of the essence when it comes to treatment, Dellinger said. “There’s an increase in mortality for every hour you delay antibiotics,” he added.
One of the big problems is that there is no rapid test for sepsis, Dellinger explained. People can show up in the emergency room with vague and disparate symptoms.
“People are just going to feel terrible,” he said. “Their blood pressure will be very low and they may have symptoms from the original site that was infected. They may have trouble breathing and low oxygen levels.”
Along with antibiotics, patients with sepsis may also need intravenous fluids and medications to pump up blood pressure. Some patients will need to be put on breathing machines if they aren’t getting enough oxygen, Dellinger added.
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