How Should We Screen for Sepsis?


  • Organ dysfunction is one of the defining characteristics in the current definition of sepsis.
  • Many of the markers currently in use are nonspecific.
  • Organ dysfunction and injury are separate processes that need to be differentiated.
  • Understanding ways dysfunction can be better detected will aid in earlier patient identification.


  1. Organ dysfunction is one of the 3 defining characteristics of sepsis and is important in the absence of a “gold standard” identifier for sepsis.
  2. It is both important and difficult to identify and differentiate organ dysfunction from infection and a dysregulated host response in sepsis patients.
  3. Organ dysfunction is dependent upon:

    a. The host response to sepsis

    b. Dysregulation of the host response

    c. Terminology: frequently dysregulation, injury and failure are used interchangeably.

    Dysfunction should be used if the process may possibly be reversible.
    Failure should be used if the process is considered irreversible.

4. Clinical criteria and objective data exist to denote the dysfunction of various
organs. However, these markers may be non-specific and may
occur late in the course of sepsis.

a. Combinations of clinical and objective markers may improve the ability to detect organ dysfunction.

5. The interrelationship between different organ dysfunctions is not known

Areas For Future Improvement

  1. The best organ pattern differentiating positive and negative outcomes need to be developed.
  2. Therapeutic targets should focus on prognosis markers and correction of organ dysfunction.
  3. Better tools to link the organ dysfunction is actually sepsis related.


  • The relationship between markers and actual organ dysfunction remains elusive.
  • Clinicians need to differentiate changes in organ markers based on infection versus other physiologic changes/insults.
  • Organ system markers should provide actionable information BEFORE injury has occurred.

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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 (, or video chat.