Sepsis covers a broad spectrum of illnesses that vary widely in mortality and cause
Authors suggest “sepsis” may be too broad a term for a large range of disease manifestations
Abstract: https://www.acpjournals.org/doi/10.7326/M24-0400
URL goes live when the embargo lifts
An analysis of sepsis presentations and mortality rates observed a 30-fold variation in mortality rates among patients with suspected sepsis depending on infection site, organ dysfunction, and their distinct combinations. According to the authors, their observation of a wide range of disease manifestations and outcomes begs the question whether it is appropriate and helpful to group all these infections together as 1 syndrome with a common descriptor and common treatment plan, especially those at low risk for poor outcomes. The analysis is published in Annals of Internal Medicine.
Researchers from Harvard Medical School and Harvard Pilgrim Health Care Institute conducted an analysis of 74,858 patients with suspected sepsis in 5 Massachusetts hospitals between June 2015 and August 2022 to elucidate the heterogeneity of sepsis by characterizing the breadth of infection sites, organ dysfunctions, and outcomes. The authors found that common comorbidities of suspected sepsis included hypertension (69%), diabetes (35%), heart failure (28%), and chronic lung disease (28%). About 30% of patients were admitted to intensive care, and about 9% died in the hospital. The authors note that there was a 30-fold variation in crude deaths depending on the primary site of infection, ranging from tick or vector-borne infections causing 1% of deaths to 33% from bacteremia. Similarly, there was a 13-fold variation in crude deaths across organ dysfunctions, ranging from 2.2% from decline in systolic blood pressure to 27% from respiratory failure requiring intubation, and mortality rates increased with successively more organ dysfunctions but still varied widely depending on which organs were involved. These findings echo other studies that have also documented divergent sepsis phenotypes but extends them by systematically characterizing the breadth of different sepsis manifestations and their mortality rates.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the corresponding author, Michael Klompas, MD, MPH, please contact mklompas@bwh.harvard.edu.
