Half of patients who develop severe condition due to an infection die within two years, shocking study suggests

By: dailymail Posted On: October 15, 2024 View: 71

Published: 18:01 EDT, 14 October 2024 | Updated: 11:03 EDT, 15 October 2024

Half of patients admitted to hospital with sepsis die within two years, according to a study.

The life-threatening condition can occur when the body's immune system — which usually helps to fight infection — overreacts to an infection and attacks it's own organs.

According to the World Health Organization (WHO), sepsis kills 11 million people worldwide each year, while in the UK it kills an estimated 48,000 per year.

Danish researchers investigated factors that could predict the outcomes for 714 patients admitted to an emergency medical department with sepsis.

Researchers found the risk of death was seen to increase if that patient had heart disease, cancer, dementia or if they had been previously hopsitalised with sepsis within the last six months.

The life-threatening condition can occur when the body's immune system ¿ which usually helps to fight infection ¿ overreacts to an infection and causes damage to organs

In a report in 2020, the WHO highlighted limitations and gaps in knowledge about sepsis outcomes and called for prospective studies to investigate long-term outcomes for sepsis patients.

Dr Finn Nielsen, a senior scientist in the Department of Clinical Epidemiology at Aarhus University Hospital, Denmark, established the sepsis research group in his emergency department in 2017.

The study examined outcomes among patients admitted with sepsis between October 2017 and the end of March 2018 using data on deaths from the Danish registry systems, which provide up-to-date information on all Danish citizens.

WHAT IS SEPSIS?

Sepsis occurs when the body reacts to an infection by attacking its own organs and tissues.

Some 44,000 people die from sepsis every year in the UK. Worldwide, someone dies from the condition every 3.5 seconds.

Sepsis has similar symptoms to flu, gastroenteritis and a chest infection.

These include:

Slurred speech or confusion
Extreme shivering or muscle pain
Passing no urine in a day
Severe breathlessness
It feels like you are dying
Skin mottled or discoloured

Symptoms in children are:

Fast breathing
Fits or convulsions
Mottled, bluish or pale skin
Rashes that do not fade when pressed
Lethargy
Feeling abnormally cold

Under fives may be vomiting repeatedly, not feeding or not urinating for 12 hours.

Anyone can develop sepsis but it is most common in people who have recently had surgery, have a urinary catheter or have stayed in hospital for a long time.

Other at-risk people include those with weak immune systems, chemotherapy patients, pregnant women, the elderly and the very young.

Treatment varies depending on the site of the infection but involves antibiotics, IV fluids and oxygen, if necessary.

Source: UK Sepsis Trust and NHS Choices

A total of 2,110 patients with suspected infections were included in the study, and 714 of them developed sepsis.

Researchers found that after a median of two years, 361 (50.6 per cent) of the patients with sepsis had died from any cause, including sepsis.

Unsurprisingly they also found older age increased the risk of death by 4 per cent for every additional year of age.

Furthermore, a history of cancer more than doubled the risk (121 per cent), while ischaemic heart disease — a condition in which the arteries supplying blood to the heart narrow or become blocked by a build-up of fat — increased the risk by 39 per cent.

In addition, dementia increased the risk by 90 per cent, and previous admission with sepsis within the last six months increased the risk by 48 per cent.

Dr Nielsen, who is a specialist in emergency medicine, cardiology and internal medicine, said: 'Our study relied on a sepsis database, which provided valuable information based on prospectively collected patient data. Unlike frequently used routine registry data, this approach minimised errors, and allowed for more accurate and detailed insights into sepsis effects.'

However, as the study was carried out in a single centre in Denmark, further research in larger, prospective studies is needed.

Addressing the European Emergency Medicine Congress Dr Nielsen said: 'We have attempted to address some of the gaps in our understanding of sepsis epidemiology.

'We have contributed with an investigation that, unlike many other studies, is based on prospective electronic health record-based research.

'Similar but larger studies of sepsis-related outcomes need to be repeated across departments, regions and countries to obtain a comprehensive epidemiological picture of sepsis, including the long-term prognostic aspects of physical, mental and cognitive disorders, and the potential impact of these factors on the risk of death.'

Dr Nielsen and his colleagues tried to develop a model that could predict the risk of death over the longer term but found that its predictive power was not good enough.

Dr Barbra Backus is chair of the European Society for Emergency Medicine (EUSEM) abstract selection committee and an emergency physician in Rotterdam, The Netherlands, and was not involved with the research.

She said: 'Sepsis is a serious and potentially fatal medical condition. The incidence of sepsis is increasing in several countries, yet so far, there has been limited, reliable information about long-term outcomes for patients who develop sepsis.

'This study has shown certain risk factors that should alert clinicians to the risk of patients with sepsis at an increased risk of dying, so that they can monitor them and follow them up more closely.

'More research is needed to help us better understand the risk factors for an increased risk of dying from sepsis, which can help to improve treatment.'