Sepsis Mortality Rates Decreasing
Severe sepsis can be life threatening; approximately one out of three patients die from severe sepsis in the hospital.A recent study from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) published online in Critical Care Medicine shows a significant decrease in severe sepsis mortality rates over the past 20 years. Researchers looked at data from patients with severe sepsis enrolled in clinical trials and found that in-hospital mortality rates decreased from 47 percent between 1991 and 1995 to 29 percent between 2006 and 2009.
What’s interesting about these numbers is that during this time period there wasn’t any new pharmacological treatments developed for severe sepsis. The results suggest, according to researchers, that improvements in patient outcomes and care can be accomplished by working with existing treatments in a novel way.
According to Boston Medical Center, severe sepsis affects approximately one million Americans every year and it occurs when a local infection causes other organs in the body to fail. For example, a patient could have an infection like pneumonia, but a counterproductive immune response results in damage to organs, such as onset kidney failure, an altered mental status, and/or dangerously low blood pressure.
The study was led by senior author, Dr. Allan J. Walkey, assistant professor of medicine at BUSM, and attending physician of pulmonary, critical care, and allergy medicine at BMC. Previous studies have suggested that having more critical care physicians providing care, earlier initiation of antibiotics, more targeted delivery of intravenous fluids, and more gentle mechanical ventilation may improve outcomes of patients with severe sepsis. However, according to researchers, whether or not the findings from these past studies were implemented into routine practice and were associated with improved severe sepsis patient outcomes in the real world was previously unclear. To avoid administrative data issues and determine trends in patients prospectively identified as having severe sepsis, this study looked at data from patients with severe sepsis enrolled in 36 multicenter clinical trials from 1991 to 2009.
“Even without new drugs or technologies to treat severe sepsis, our study suggests that improving the ways in which we recognize and deliver care to patients with severe sepsis could decrease mortality rates by a magnitude similar to new effective drug,” Walkey says.
Additional studies are needed to determine what specific changes in care have had the most impact on decreasing the mortality rates of patients with severe sepsis.