Sepsis: An Underestimated Killer

5/1/18 8:00 AM

A patient walks into the hospital room presenting abnormal symptoms — the patient has patches of discolored skin, difficulty breathing, the chills. The doctor diagnoses the patient’s condition as a simple skin infection. The patient is given a course of antibiotics and the doctor reassures the patient’s family that all will be well soon. However, to the doctor’s and the family’s dismay, the patient’s condition worsens. The patient develops a high temperature of 102° F, a heart rate higher than 90 beats per minute, and abdominal pain. Upon observing the onset of such symptoms, the doctor immediately changes the patient’s diagnosis to severe sepsis and administers treatment. However, it is too late to resuscitate the patient.

Unfortunately, this patient’s experience is not unique. Sepsis affects approximately 1.5 million people in the US every year with a mortality rate that ranges from 28-50%. The Journal American Medical Association (JAMA) reports that up to 50% of all hospital deaths are related to sepsis, with most cases present upon admission. In fact, sepsis is the most costly indication in hospitals across the US, costing hospitals nearly $24 billion annually.

What is sepsis?
This is a tricky question as definitions are constantly evolving as new medical evidence becomes available. However, a terse definition does exist: sepsis is a life-threatening organ dysfunction caused by a dysregulated response to infection. Septic shock, a commonly used medical term, is a type of sepsis characterized by circulatory and cellular/metabolic dysfunction which is associated with a higher risk of mortality. (Learn more about sepsis definitions).

From a molecular biology perspective, sepsis results from the overproduction of cytokines. Cytokines are proteins that cause inflammation, and an overproduction of cytokines leads to excessive inflammation and potentially organ failure.

Who does it affect?
Sepsis can affect anyone, however, it is more prevalent among those who have chronic conditions and weakened immune systems. Another risk factor is age — sepsis is commonly diagnosed among older patients, and especially those with other risk factors such as diabetes or AIDS.

Sepsis is a widespread, costly, and life-threatening condition that kills more Americans than than AIDS, prostate cancer and breast cancer combined.

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