Sepsis fight complicated by vague guidelines, data variations

Sepsis affects one in 10 patients and is considered one of the deadliest, costliest hospital-acquired infections. But the fight to prevent it is made more difficult due to a combination of ineffective messaging and variations in measurement, according to Slate and a new study by the Centers for Disease Control and Prevention (CDC). 

It was only recently, in the wake of the death of 12-year-old Rory Staunton, that the CDC even listed sepsis in its index of medical terms,Slate reported. But the addition didn't clarify vague guidelines that seem more likely to foster paranoia than awareness, noting that the deadly infection can "affect any part of the body" and "occur even after a minor infection."

These problems, the article notes, are less a failure on the part of the CDC and more a symptom of an ongoing debate within the healthcare community on how to diagnose and screen for sepsis. Research earlier this year confirmed that the long-held diagnosis criteria for the condition typically leads to an overdiagnoses of sepsis and it also overlooks about one-eighth of septic patients. Instead, providers are now advised to screen for key symptoms: confusion indicating altered mental status, systolic blood pressure of 100 mmHg or less, and breathing rates of 22 or less per minute.

Further muddying the waters, a new study published in the CDC's Morbidity and Mortality Weekly Report indicates broad variation in mortality rate estimates for sepsis depending on the public health data used. Researchers said administrative claims data indicated a 15 percent to 140 percent higher rate of sepsis deaths than those found by death certificates. 

"Current efforts focused on evaluating linkages of administrative claims data derived from inpatient medical records with death certificates will improve understanding of how mortality estimates from death certificates and administrative claims data should be interpreted," the authors wrote.

To learn more:
- here's the Slate article
- read the CDC's sepsis fact sheet (.pdf)
- here's the study abstract

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