Predicting sepsis earlier

As one of the nation's leading providers of health and care, HCA Healthcare is committed to increasing public awareness of sepsis and, as a learning health system, and finding new ways to predict sepsis earlier and save lives.

Sepsis—which can occur in the community at large and in hospitals— is more deadly than prostate cancer, breast cancer and AIDS, combined, with approximately 1.5 million cases annually. It's the number one cause of non-cardiac deaths in intensive care units, and the eleventh leading cause of death overall, with more than 258,00 fatalities in the United States each year.

At HCA Healthcare, we are leveraging our size and scale - 168 hospitals and more than 20 million patient encounters yearly - and Big Data from our Clinical Data Warehouse to identify sepsis earlier. This is vitally important, because unlike many other conditions, there is a "point of no return" in the progression of sepsis after which survival precipitously plummets. Detecting sepsis earlier helps patients avoid complications and saves lives. Read on for more information about sepsis.

What is sepsis?

Sepsis is a potentially life-threatening complication of an infection. Not everyone who has an infection will develop sepsis, yet everyone with sepsis has an infection. Sepsis occurs when the body responds to an infection by releasing chemical agents called toxins into the bloodstream. These toxins trigger inflammation throughout the body that can damage multiple organ systems. If sepsis becomes severe, it progresses to septic shock in which blood pressure drops dramatically and organs don't get enough oxygen to continue to function. Today's best science dictates the earliest recognition of these changes to prevent death, but the risk is still substantial. Our computer systems are helping us to develop real-time monitoring to predict who will get sepsis and intervene early. We believe this will be the new standard of care in the near future.

Who can get sepsis?

Anyone can develop sepsis, but the elderly, infants and children, or those with weakened immune systems, and those that are already significantly ill are most at risk. Hospital patients could also develop sepsis after surgery via an infection caused by bacteria in intravenous (IV) lines or catheters, for example. HCA Healthcare has a strong history of national leadership in infection prevention and patient safety programs to eliminate healthcare-associated infections.

What are the symptoms of sepsis?

If an infection occurs anywhere - on the patient's skin, in the urinary tract, or in the lungs, as with pneumonia - patients have an increased risk for developing sepsis. This is one reason why it is important to seek care from a physician immediately if you have signs of an infection that is worsening. Remember, most people who have and infection will never develop sepsis, but everyone with sepsis has an infection. According to the United States Centers for Disease Control and Prevention (CDC) the warning signs of sepsis include:

• S - Shivering, fever or feeling very cold
• E - Extreme pain or general discomfort
• P - Pale or discolored skin
• S - Sleepy, difficult to rouse, confused
• I - "I feel like I might die"
• S -Short of breath

How is sepsis treated?

Sepsis awareness is important, because early detection is critical to survival. Each hour antibiotic administration is delayed, the risk of death increases by eight percent. If sepsis is suspected, antibiotics and large amounts of intravenous fluids are administered as soon as possible. Patients also may be given oxygen and other supportive therapy. Sometimes, surgery is performed to remove tissue damaged by the infection. However, the key is early detection. Unlike many other conditions, there is a "point of no return" in the progression of sepsis after which survival decreases drastically. Recognizing the tell-tale signs of sepsis and seeking care immediately is the key to survival.

How is sepsis prevented?

Prevent sepsis by preventing infections that can lead to it. It is also critical that everyone:

• Get appropriate, recommended vaccinations to prevent illnesses,
• Practice thorough hand hygiene by washing your hands frequently, and
• Clean cuts or wounds thoroughly if you are injured.

If you already have an infection, you can help lessen the chances of developing sepsis or prevent it entirely by:

• Taking antibiotics as prescribed;
• Finishing the entire course of antibiotics;
• Seeking medical help if an illness or infection doesn't improve.

For patients who come to the hospital with sepsis or are at risk of sepsis in the hospital, we are bringing the tools of the best science, computerized monitoring, and "big data" to make sure that we stop sepsis early today and even predict and prevent sepsis tomorrow.