The results should provide food for thought for medical device developers seeking to create devices based on value.
Sepsis occurs when immune chemicals that are released in the body to fight an infection end up causing widespread inflammation, blood clots and leaky vessels, according to the National Institute of General Medical Sciences. It is usually caused by other medical conditions like infections in the lungs, urinary tract, skin, abdomen or other parts. Invasive medical procedures can introduce bacteria into the bloodstream and cause sepsis.
About 1 million Americans will have sepsis per year with 28–50% of those patients dying.
“Many people think infections and sepsis are short-term illnesses and that once patients are discharged from the hospital, they are better,” said Sachin Yende, M.D., senior author on the study and associate professor in the Pitt School of Medicine’s departments of Critical Care Medicine and Clinical and Translation Sciences, in a press release. “But all research to date shows that sepsis has serious, lingering consequences, and patients continue to have problems well after they are discharged.”
The Centers for Medicare and Medicaid Services tracks readmissions for heart attacks, heart failure, chronic pulmonary disease (COPD) and pneumonia. The Affordable Care Act and the Hospital Readmission Reduction Program allow for the hospitals to be penalized if they have high readmission rates for these conditions.
Yende and his team analyzed the 2013 Nationwide Readmissions Database that has 49% of U.S. inpatients for the 4 conditions and sepsis. Sepsis accounted for 12.2% of readmissions, 6.7% was heart failure, 5% was pneumonia, 4.6% was COPD and 1.3% was heart attack.
The researchers also determined that sepsis is costly, with the average cost for readmissions being $10,070. In comparison, pneumonia costs $9,533, heart attack costs $9,424, heart failure costs $9,051 and COPD costs $8,417.
“This really puts in perspective how important sepsis is,” said Florian B. Mayr, M.D., lead author on the study and a faculty member in Pitt’s Department of Critical Care Medicine and the Center for Health Equity Research and Promotion at the VA Pittsburgh. “If we, as a nation, place such high emphasis on reducing readmission for the other four conditions, then we really need to look for opportunities to improve outcomes for sepsis, which has a higher rate of readmission than heart failure. People who survive an initial episode of sepsis often don’t do well. They return to the hospital frequently, accrue new health conditions and have significantly elevated death rates.”
Another recent study out of Eastern Virginia Medical School in Norfolk, Va. reported that they had success in treating patients with sepsis who were at a high risk of sudden death, according to an article from NPR. Dr. Paul Marik at Sentara Norfolk General Hospital gave a patient who had failing lungs and kidneys a dose of intravenous corticosteroids and thiamine. The patient was recovering by the next morning.
Marik regularly started treating his sepsis patients with the vitamin and steroid infusion. After 50 patients were treated, he published his results in the journal Chest. Only 4 out of 47 patients died in the hospital, but they died from their diseases, not sepsis.
The University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System research was published in the Journal of the American Medical Association and was funded supported by National Institute of General Medical Sciences grants.
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