Sepsis indications may include diagnosis of bacterial versus viral infections and staging.
|Multiple Biomarkers for Sepsis Assessment|
|Diagnosis: Differentiate between infectious vs. non-infectious etiology at admission||Determine the need for treatment with broad spectrum antibiotics vs. other intervention associated with non-infectious etiology|
|Staging: Determine where the patient is on the disease continuum (bacteremia vs. sepsis) at admission||Guide appropriate aggressiveness of treatment and resource allocation for optimal outcomes at lower cost|
|Monitoring: Assess response to treatment. Determine if empiric antibiotics can be de-escalated after initiation of treatment.||Determine whether empirical antibiotic treatment can be weaned (e.g., remove one of the cocktail or all antibiotics)|
Sepsis Disease State Overview
Sepsis is a clinical syndrome that complicates severe infection. It is characterized by systemic inflammation and widespread tissue injury. A continuum of severity exists from Systemic Inflammatory Response Syndrome (SIRS) to sepsis to septic shock and Multiple Organ Dysfunction Syndrome (MODS). SIRS is nonspecific and can be caused by ischemia, inflammation, trauma, infection, or several insults combined. Although sepsis has diverged from SIRS criteria for diagnosis and management, focusing more on infectious etiologies, the pathophysiologic processes of sepsis and noninfectious SIRS are remarkably similar, making a discussion of SIRS in critical illness appropriate.
Venn diagram showing overlap of infection, bacteremia, sepsis, systemic inflammatory response syndrome (SIRS), and multi-organ dysfunction.
Complications vary based on underlying etiology and may include:
- Respiratory failure, and hospital-acquired pneumonia
- Kidney failure, electrolyte abnormalities
- Gastrointestinal bleeding
- High blood sugar
- Deep vein thrombosis or disseminated intravascular coagulation
- There were 2.9 million emergency department visits in the U.S. with suspected SIRS and 2 million admissions.
- There were 5.2 million cultures ordered through the emergency department and 8.1 million from inpatients.
- 258,000 deaths in the US annually, or 1 person every 2 minutes
- Sepsis is responsible for nearly $24 billion in annual costs, which represents 6.2% of all hospital costs, making sepsis the most expensive condition to treat in the entire U.S. healthcare system.
- Spending rose by $3.4 billion (19%) between 2011 and 2013.
- The mean expense per stay is $18,000, which is 70% more expensive than the average hospital stay.
- In 2013, sepsis accounted for 8.2% of all Medicare costs.