Detecting Sepsis: A Silent Killer
Sepsis is considered a silent critical illness that can lead to organ damage and even death. In this installment, we identify tools for detecting sepsis before it is too late.
What is Sepsis?
Sepsis is a life-threatening condition that occurs when the body’s response to an infection injures the body’s own tissues and organs. The body “turns on itself.”
Bacterial infections are the most common cause of sepsis, but sepsis can also be caused by fungal, parasitic, or viral infections.
Why is Sepsis So Dangerous?
There are at least three reasons.
First, sepsis is common. A few years ago, the CDC estimated that over 1.7 million adults in the U.S. develop sepsis each year, leading to about 270,000 deaths.
Second, sepsis can quickly evolve to a life-threatening condition. For that reason, sepsis merits the same degree of caution and responsiveness as a stroke or heart attack. Like an acute stroke or heart attack, sepsis is a medical emergency that requires rapid diagnosis and treatment.
Third, sepsis is a “silent” critical illness. For timely and accurate detection, sepsis requires attentive assessment of subtle changes in the patient’s condition.
Today, doctors diagnose sepsis using (a) the Systemic Inflammatory Response Syndrome (SIRS) Criteria, or (b) the Sequential Organ Failure (SOFA) Score.
Under the SIRS Criteria, a patient is diagnosed with sepsis if an infection is clinically suspected and at least 2 of these 4 criteria are met:
- Temperature above 100.4 F or below 96.8 F
- Heart rate faster than 90 beats per minute
- Respiratory rate faster than 20 breaths per minute, a paCO2 under 32 mmHg, or the need for invasive mechanical intubation for an acute process
- White-blood-cell count over 12 or under 4, or immature band forms over 10%
The SOFA Score is a newer, more-complex tool that focuses on signs of organ dysfunction. Outside the hospital or in the ER, healthcare providers may use a simpler version of the SOFA Score, known as “quick SOFA” or “qSOFA.”
What To Do?
Detecting sepsis early, and pursuing treatment quickly are key. If a patient has an infection that is not getting better, or even if the patient has merely a suspected source of infection such as a catheter or a surgical anastomosis, healthcare providers should screen for sepsis using the SIRS Criteria. As concern increases, the patient’s family members should promptly request, and providers should quickly obtain, a SOFA Score.