Sepsis treatment: Earlier action in hospitals can mean the difference between life and death

Aggressive and quick treatment in the emergency department improves the chances that patients who have suspected cases of sepsis will survive.

Although the Centers for Disease Control and Prevention has urged earlier treatment of broad-spectrum antibiotic agents and intravenous fluids, and some hospitals have taken up the charge, clinicians were skeptical that the earlier treatment actually leads to better outcomes. So, researchers led by Christopher W. Seymour, M.D., from the University of Pittsburgh School of Medicine analyzed data from 50,000 patients from 149 New York hospitals, which are required to implement the protocols and report on the treatment of sepsis.

The results of the study, published Sunday in the New England Journal of Medicine, find that for every hour clinicians fail to complete a well-known antisepsis protocol, mortality rates in the hospital increase by as much as 4%.

“Our data shows that hospitals really need to do this at the outset, especially at the emergency department when they suspect sepsis,” Seymour told STAT. “It can be lifesaving.”

The findings are huge, said Claran Staunton, the father of Rory Staunton, the 12-year-old boy from New York City who died from sepsis and inspired the state to impose the regulations. “I have met a lot of the families saved in New York because they had to rule out sepsis,” Staunton told USA Today. “I’ve been to the grave sites in other states where there were no protocols."

Meanwhile, a separate study presented Sunday at the 2017 American Thoracic Society International Conference finds that patients with sepsis are less likely to receive immediate antibiotic treatment when they are seen in overcrowded emergency departments.

The study examined the records of 945 patients admitted to an intensive care unit after being seen in the ER of two community hospitals and two tertiary referral centers in Utah between July 2013 and December 2015.

Each one-hour delay in antibiotics increased the odds of a patient dying from sepsis by as much as 10%, said lead author Ithan Peltan, M.D., of the Intermountain Medical Center and the University of Utah School of Medicine, Salt Lake City.

“Our findings suggest adequate staff and diagnostic resources are critical to effective sepsis care,” Peltan said in the study announcement. “Hospitals should also consider sepsis care reorganization to bypass competing demands on clinicians and diagnostic resources.”