Why is Sepsis Dangerous?

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. Did you know that 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 caused 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 can 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?

Very dangerous!

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.

Sepsis can also impact your health in the future.

Researchers analyzed data for more than 2.2 million US patients who were hospitalized for at least 2nights for nonsurgical reasons between 2009 – 2019. Alarmingly, in the period after hospitalization (a span of up to 12 years), people who had sepsis in the hospital had a 27% higher risk of death and were 38% more likely to return to the hospital for any cause, as compared to those who did not have sepsis.

Furthermore, those who had sepsis were 43% more likely to be readmitted for a cardiovascular problem, such as stroke, heart attack, irregular heartbeat or heart failure (the number 1 reason for rehospitalization).

According to the lead study author, the findings “indicate that after hospitalization with sepsis, close follow-up care is important, and it may be valuable to implement cardiovascular prevention therapies with close supervision.”

Based on these findings, if you (or a loved one) had sepsis while hospitalized, I suggest you seek regular follow-up care with a cardiologist or other heart specialist.

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, including people who:

• Are over 75 years old.
• Have diabetes.
• Live with a weakened immune system, such as those undergoing chemotherapy. treatment or who recently had an organ transplant.
• Have a genetic disorder that affects their immune system, such as people with Down’s syndrome or sickle cell disease.
• Recently had surgery or a serious illness.

Additionally, others with a higher risk include:

• women who have just given birth, had a miscarriage or had an abortion.
• Babies under 1, particularly if they’re born early or their mother had an infection while pregnant.

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.

Symptoms.

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.

Diagnosing sepsis.

Early, thorough treatment increases the chance of recovery. Importantly, people with sepsis need close monitoring and treatment in a hospital intensive care unit because people with sepsis may need lifesaving measures to stabilize breathing and heart action.

Doctors may use different medications, including IV fluids, antibiotics, and vasopressors to narrow blood vessels and help increase blood pressure. Additionally, doctors may use insulin for blood sugar levels, or painkillers.

Importantly, patients often need supportive care that can include oxygen or a ventilator to help with breathing. And a patient may need dialysis if kidney issues arise.

Lastly, in some cases, doctors may need to operate to remove sources of infection, such as pus, infected tissues or dead tissues.

A serious warning about medication for sepsis.

Researchers reviewed the cases of over 7,500 hospitalized adults with suspected sepsis. The study, published in 2024, found giving patients a combination of vancomycin and piperacillin-tazobactam was associated with increased mortality risk compared to patients who received a combination of vancomycin and cefepime.

Importantly, the authors state their findings suggest that doctors should not give piperacillin-tazobactam to patients with sepsis who do not have anaerobic bacterial infections.

I realize these terms are hard-to-pronounce and understand. However, the important thing to note is that if you or your loved one develop sepsis, ask the doctor if they can prescribe something other than piperacillin-tazobactam.

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 4-9% 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.

Are there long-term effects of sepsis?

Unfortunately, up to 50% of sepsis survivors experience post-sepsis syndrome (PSS), a serious condition can affect sepsis survivors of any age, including children. Research shows that many sepsis survivors experience new or worsened physical, cognitive, and psychological problems for months to years after hospital discharge, whether they were treated in an intensive care unit (ICU) or in a general ward or unit.

PSS cause long-term physical and/or psychological symptoms.

Physical difficulties due to PSS include:

• Difficulty sleeping, either difficulty getting to sleep or staying asleep. 
• Fatigue and lethargy.
• Shortness of breath, difficulty breathing.
• Disabling muscle or joint pain.
• Swollen limbs
• Repeat infections, particularly in the first few weeks and months following the initial bout of sepsis.
• Poor appetite.
• Reduced organ function, such as issues with the kidney, liver, and/or heart
• Hair loss.
• Skin rash.

Psychological or emotional issues due to PSS can include:

• Hallucinations.
• Panic attacks.
• Flashbacks.
• Nightmares.
• Decreased cognitive (mental) functioning.
• Loss of self-esteem.
• Depression.
• Mood swings.
• Difficulty concentrating.
• Memory loss.
• Post-traumatic stress disorder (PTSD).

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.

Prevent infections.

Try to prevent infections by properly managing any chronic conditions and by getting all recommended vaccinations.

Choose the “right” hospital for surgery.

Not all hospitals provide the same level of monitoring to identify signs of sepsis after patients undergo surgery. Fortunately, you can look up your hospital, or hospitals in your area, on The Leapfrog Group’s website to see their score on post-surgical sepsis infections.

Practice good hygiene.

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.

Be sure to wash your hands in these circumstances, as recommended by Johns Hopkins Medicine:

Before you:

• Eat.

After you:

• Use the toilet.
• Blow your nose, sneeze and/or cough.
• Touch an animal, handle pet food/treats.
• Change a diaper.
• Help someone with toileting.
• Handle trash.

Before and after (and during as needed) you:

• Care for a sick person.
• Clean a wound or cut.
• Prepare food.

Additionally, make sure you keep all wounds clean and covered until they heal. And if you have a rash or infected area that is not getting better, or is getting worse, see your doctor! Better safe than sorry.

Avoid antibiotic overuse.

Lastly, antibiotic overuse contributes to these difficult infections, so practice safe antibiotic usage. For more information, read Are Antibiotics Helpful or Harmful? What You Need to Know.

Know the signs and symptoms of sepsis.

Watch out for the following signs of sepsis:

• High heart rate or low blood pressure.
• Fever, shivering, or feeling very cold.
• Confusion or disorientation.
• Shortness of breath.
• Extreme pain or discomfort.
• Clammy or sweaty skin.

Act fast if you suspect sepsis.

Sepsis is a medical emergency and you should act accordingly. If you or your loved one has any of the above signs, and/or has an infection that’s not getting better or is getting worse, get medical care immediately. And make sure you ask your healthcare professional if the infection could lead to sepsis.

Learn more about infection prevention.

Sepsis is dangerous. To learn more about reducing your risk of infections, including sepsis, read these 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 2-6-26.