For most of us, it’s scary to think about staying in the hospital. Certainly, no one goes to the hospital expecting to get sicker, but unfortunately it happens. And sepsis is a common cause of serious harm to hospitalized patients. Although over 40% of US adults have never heard of sepsis, it is the leading cause of death in US hospitals. What is sepsis? How do you get it? And why is sepsis dangerous?
The what, how and why of sepsis.
What is sepsis?
Sepsis is a dangerous, life-threatening medical condition caused by the body’s extreme response to an infection. In short, sepsis is blood poisoning by bacteria. Sepsis can lead to tissue damage, organ failure, amputations and death. Septic shock, the most severe, version of sepsis, occurs when a body-wide infection leads to dangerously low blood pressure.
How common is sepsis?
Unfortunately, sepsis is dangerous and common, and can even be deadly. According to the NIH, more than 1.7 million people Americans develop sepsis each year. Moreover, almost 270,000 people die every year from sepsis in the US. Shockingly, about 1/3 of patients who die in the hospital have sepsis.
A 2020 report from the World Health Organization estimates that sepsis causes 20% of deaths worldwide. Unsurprisingly, the report states sepsis disproportionately affects those living in low- and middle-income countries.
However, the report also finds that children are disproportionately impacted. Importantly, the report states the limited availability of data from low- and middle-income countries means the true number of cases and deaths is unknown.
How does sepsis develop?
Many types of microbes cause sepsis, including bacteria, fungi, and viruses. However, bacteria are the most common cause. Additionally, antibiotic-resistant infections can lead to sepsis. In many cases, doctors cannot identify the source of infection.
When a person has an infection, their body releases immune chemicals into the blood to combat the infection. When this response is overactive, the chemicals can cause widespread inflammation, leading to blood clots and leaky blood vessels. The restricted blood flow deprives organs of nutrients and oxygen and leads to organ damage.
No matter the cause, sepsis is a tricky one – it occurs unpredictably and can progress rapidly.
Why is sepsis dangerous?
In severe cases, one or more organs fail. In the worst cases, the patient’s blood pressure drops, the heart weakens, and the patient spirals toward septic shock. Once this happens, multiple organs—lungs, kidneys, liver—may quickly fail, and the patient can die.
How dangerous is sepsis?
A 2020 report of an analysis of Medicare patients found that 10% of patients with non-severe forms of sepsis died while in the hospital or within a week of discharge. Moreover, 60% with non-severe forms of sepsis died within three years.
In comparison, patients with septic shock fared significantly worse. In fact, 40% of those with septic shock died while in the hospital or within a week of being discharged, and 75% died within three years.
Additionally, patients with other chronic health conditions, have a higher risk of sepsis and an increased risk of sepsis-related death.
How do patients develop sepsis?
Sepsis can develop from an infection in one part of the body, such as the lungs, urinary tract, skin, or abdomen, including the appendix. Additionally, invasive medical procedures, such as inserting a tube into a vein, can introduce bacteria into the bloodstream and lead to sepsis.
Who can get sepsis?
Although anyone can get sepsis, some patients have a higher risk. For example, infants, children, seniors are more at risk. Additionally, people with serious illnesses or injuries, such as AIDS, diabetes, cancer and liver disease are more prone.
Additionally, those who had an organ transplant and/or use medications to suppress the immune system have a higher risk.
Where do patients contract sepsis?
Although people can develop sepsis at any point in their healthcare journey, research shows the majority of sepsis cases originate in the community, not in the hospital.
For instance, a review of sepsis cases at the University of Kansas Medical Center found that 60% of sepsis patients came through the emergency department, 15% were transferred in from other places and only 25% developed while the patient was in the hospital.
Another study, published in 2020, found that most patients with sepsis or septic shock experienced their onset outside of the hospital, but had recently received health care. Additionally, 42% of septic patients received antimicrobial drugs, chemotherapy, wound care, dialysis, or surgery in the 30 days before their sepsis occurred.
What are the symptoms of sepsis?
Common symptoms of sepsis are fever, chills, rapid breathing and heart rate, rash, confusion, and disorientation. Since many of these symptoms are also common in other conditions, sepsis can be hard to diagnose, especially in its early stages. For example, early signs can appear similar to a urinary tract infection or the flu.
How is sepsis diagnosed?
In addition to checking for the symptoms mentioned above, a doctor may test the blood for a white blood cell count and/or for the presence of bacteria or other infectious agents. Doctors may also use a chest X-ray or a CT scan to locate an infection.
Are there long-term effects of sepsis?
Many people who survive severe sepsis recover completely. But for some people, especially those with pre-existing chronic diseases, sepsis is particularly dangerous and may cause permanent organ damage.
Additionally, there is some evidence that severe sepsis puts people at an increased risk for future infections. Studies show that people with a history of sepsis have a higher risk of various medical conditions and death, even several years after the episode.
How do doctors treat sepsis?
After a sepsis diagnosis, most patients receive treatment in intensive care units (ICUs). Doctors try to stop the infection, protect the vital organs, and prevent a drop in blood pressure, usually with antibiotic medications and IV fluids.
The sickest patients might need a breathing tube, kidney dialysis, or surgery to remove an infection. Unfortunately, experts have been unable to develop a medicine to specifically target the aggressive immune response seen with sepsis.
In addition to using antibiotics to stop the infection, doctors may identify the source of the infection and implement “source control” measures.
Time is of the essence.
Time is the enemy. As every hour passes without treatment, the prognosis worsens significantly. In fact, research shows that death rates increase by as much as 8% for every hour that treatment is delayed.
Interestingly, a recent study found that identifying the source of the sepsis infection and implementing source control measures within 6 hours resulted in a 29% reduction in 90-day mortality rates.
Furthermore, studies show that rapid diagnosis and treatment could prevent as many as 80% of sepsis deaths.
What can you do to reduce your risk of sepsis and associated harm?
There are steps that patients and families can take to reduce their risk of exposure to germs that can lead to sepsis infections. Realize germs can be airborne or on objects, including on medical equipment.
One of the most important actions for sepsis prevention is regular hand washing for at least 20 seconds. Not only should you frequently wash your own hands, you should make sure that anyone in a medical setting also washes their hands before they touch you or medical equipment that will touch your body.Learn more about infection prevention.
To learn more about reducing your risk of infections, including sepsis, read my blog posts:
- Germs in Hospitals and Doctor Offices – Watch Out!
- Protect Yourself from Superbugs.
- How To Protect Yourself from Hospital Infections.
- Handwashing in Healthcare Could Save Your Life!
- What’s Your Hospital’s Safety Record? Is Your Hospital Safe?
NOTE: I updated this post on 7-20-22.
My friend Angelina just passed away from sepsis on 6/14/2022. May she Rest In Peace.
Tia,
I am so sorry for your loss.
Roberta
My 44 yr old cousin died Saturday Oct. 9th on his birthday of Sepsis. People need to know more about this deadly illness !
Theresa Ann,
I’m sorry to hear about the loss of your cousin.
Roberta
I took my husband to hospital with severe pain in stomach at 2 am that came out of nowhere.
ER Dr said he had extended bladder and filled him full of {painkillers} to see a urologist. It was at the start of covid and they did not want us at hospital. I kept asking if he had an infection. He was the toughest guy I know and fit as a fiddle. He told me to run red lights on the way to ER he was in so much pain. Sent home and could not get into urologist for 3 days. Did not feel good all next day as they said he would not. They took urine off and sent him home with catheter with instruction. Did not go over ER report and never saw Dr again after diagnosis.
He started vomiting at 5 am next morning and called back to ER said it was from the advil and to give ice chips…I decided to wait until his GP got to office and called him. Told me to get him back to ER. He was already sepsis 3 and his bowel had ruptured. It was right on scan but they just dismissed and sent home. He was airlifted to big center – they did surgery and then 12 hours later lost him to septic shock. Took 18 inches of dead intestine out of small bowel. Very preventable if they would of kept him. I don’t give a crap about covid as I want to know how many people died because they did not get good health care DURING covid and were sent home. My husband would not ever even go to ER unless he was dying…I blame myself for ever taking him home when my gut feeling told me he was really sick but they convinced me he was all right. Nurse was like a clinical robot…I will never forgive myself for not making them keep him. They finally gave me the lab and ER report to give to urologist when I was taking my poor dear husband home and trying to focus on him. Our family is heartbroken that they convinced me he was ok and I did not tell my only son 450 miles away that his dad was even at ER as his family had been very sick with covid in Denver and felt he had his plate full with that and we would see a urologist and then let him know the results. I have to live with my guilt for the rest of my life.
Linda,
I am so sorry about your loss. That is a very sad story. I hope you can forgive yourself – you did your best.
I’ve had recent gallbladder surgery and I have developed fibromyalgia like symptoms where my wrists joints are swollen and hurting and I am having a am hard time gripping with my hands. Chest is heavy and i keep having little shooting pains in my heart. Could this be a sign of an infection
Joann,
I am sorry to hear that you are having these symptoms. And I am sorry for my delayed response! I am not a medical professional – I hope you checked in with your doctor to share your concerns.
Roberta
My husband went into seizures on June 1st of this year. He was put in the ICU because he wasn’t coming out of them. On June 5th the hospital called me at 5am for approval of putting him on on a ventilator. They talked about Sepsis but never seemed to confirm that is what he had. Other than {giving him} lots of antibiotics. Blood Pressure dropping, Fevers etc. He was able to be taken off the ventilator after two days and they highly suggested he go to a Rehabilitation Hospital for two weeks. He did have other health issues such as Cancer that was supposed to be in remission. After two weeks he was released and sent home. To make a long story short, he ended back in the hospital and passed away on July 17th of Septic Shock. I had no idea what Sepsis was and how dangerous it really is. I had heard of Septic Shock but again not the details of it. Thank you for getting this information out.
Darlene,
So sorry for your loss. It sounds like you and your husband had a very difficult time. I hope your memories of your husband bring you some peace.
Take care,
Roberta
Lack of hygiene in nursing homes could cause this. Not changing the Depends the elderly wear is very bad. Be vigilant for your parent and keep after the staff to do their due diligence and wash their hands! They have to wash your parent’s hands too! My mother died April 25.2020 of enterococcus sepsis in a negligent nursing home. She was in good shape before New York State mandated lockdown. The staff abandoned her care and let her die. They will be made accountable.
Beth,
I am sorry about the loss of your mother. Thank you for sharing your sad, but important, experience.
Take care,
Roberta
I had two bouts of sepsis both happened right after dental work.. About a year after the second but, I had an infected tooth pulled. The dentist said that it was significantly infected and he was convinced that this infection caused my two sepsis attacks. After my second attack I developed liquid on the brain (normal pressure…) and have memory and balance issues. Are there any evaluation trials I can join?
Stephen,
I am so sorry to hear about your ongoing problems with sepsis! Although my work with Zaggo focuses on helping people become empowered members of their medical teams, I don’t have any specific information on clinical trials. However, I have a list of sites in our Resource Center where you can look for trials that might be right for you.
Good luck! I hope you find what you are looking for.
Roberta
Hello! Thank you so much for posting this article. It is VERY informative!!!
Dana –
I am glad you found it helpful!
Roberta
I had a left hip replacement at one hospital that my doctor chose and they gave me a flu shot. I was released 3 days later. 4 days later I woke up face down on my bed. My daughter and her husband stopped by to give me a cup of coffee. I was laying in vomit, and my breathing was more like a flutter, than normal breathing, Son-in-law called the rescue squad, I went to my hospital of my choice, which was very critical. Had flu and Pneumonia. I then had Sepsis, and Sepsis shock. My heart and lungs were shutting down. I responded to antibiotics and thankfully started getting better. Was in the hospital a week, but made a recovery. So thankful to still be here.
I’m sorry you had such a difficult time! I’m so glad you responded to treatment and have recovered. Thanks for sharing your story. Take care,
Roberta
Today marks one year to my husband went hospital for sepsis – he was given second life.
Thank you so much for posting. It is very needed information as I have a friend who had mile sepsis for well over a year and a half due to an untended kidney infection. This information is so valuable to so many people and needs to continue being put out. Most people know very little about Sepsis and the swelling part was also new to me. Very important information, thank you very very much for being the ‘stone in the shoe’ about this important topic.