SUMMARY

• The challenge of sepsis remains for most clinicians
• There is no one-size fits all approach
• Several unresolved key areas will remain with us into the next year

TOP 10 SEPSIS KEY PERSPECTIVES (in no particular order)

10. Most common cause of inpatient death in the U.S. and throughout the world

a. Incidence and mortality rates vary by country and region

9. Difficult to Diagnose

a. Diverse syndrome

b. No Gold Standard for diagnosis

c. Must determine if an infection is present or suspected and if the organ dysfunction is due to the infection

8. Survivors can have long lasting illness effects

a. Cognitive impairment

b. Functional disabilities

c. Inability for independent living

7. One of the major diagnoses leading to readmission

6. Very expensive to treat

a. Total Medicare cost of inpatient admissions (2018) = $22,439,794, 212

5. Quality Improvement Initiatives to standardize and improve sepsis management

a. Surviving Sepsis Campaign

b. New York State Department of Health (2013)

c. Centers for Medicare & Medicaid Services (2015)

4. Search for biomarkers for rapid diagnosis continues with tremendous promise

a. Increased diagnostic yield

b. Decreasing turnaround time

c. Improving outcomes

3. Tracking Sepsis Trends

a. Hospital discharge codes – vary between hospitals and change over time

b. Death records – variable and inaccurate results

c. Clinical Registries – Resource intensive

d. Retrospective case reviews – Resource intensive

e. Randomized controlled trials – does not assess incidence

f. EHR Clinical tools – IT expertise and resources needed

2. Time to antibiotics and mortality

a. Mainly consists of observational cohort studies

b. Fraught with limitations and biases

1. Antimicrobial treatment

a. Empiric therapy

b. Duration of treatment

c. Pharmacokinetic & pharmacodynamics principles for optimal dosing

CONCLUSIONS

• Sepsis remains a major global health priority
• Despite enormous progress, sepsis definition, recognition and treatment remains challenging
• As new perspectives in sepsis have evolved, key characteristics continue to prevail.
• Key factors will continue to prevail until clear new data emerges.

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Erkan Hassan is the Co-Founder & Chief Clinical Officer of Sepsis Program Optimization where he designs & oversees the implementation of solutions to optimize sepsis programs.

To discuss your organization’s Barriers of Effective Sepsis Care, contact Erkan by phone (844) 4SEPSIS (844-473-7747), email (erkan@spo.icu), or video chat.