{"id":22041,"date":"2019-06-28T18:06:21","date_gmt":"2019-06-28T18:06:21","guid":{"rendered":"http:\/\/medgoo.com\/?p=22041"},"modified":"2019-06-28T18:06:23","modified_gmt":"2019-06-28T18:06:23","slug":"a-close-look-at-sepsis-part-1","status":"publish","type":"post","link":"https:\/\/medgoo.com\/index.php\/2019\/06\/28\/a-close-look-at-sepsis-part-1\/","title":{"rendered":"A Close Look At Sepsis &#8211; Part 1"},"content":{"rendered":"\n<p>Google \u201cleading cause of death in the United States\u201d and right there in the top spot, page one, is a link to the Centers for Disease Control and Prevention (CDC), which declares heart disease the winner.<sup>(1)\u00a0 <\/sup>Yet, the American Association for Clinical Chemistry (AACC) passes this rank to sepsis. In its special sepsis issue of <em>The Journal of Applied Laboratory Medicine<\/em>, the AACC states that sepsis kills more people in the U.S. than heart attacks every year.<sup>(2)<\/sup><\/p>\n\n\n\n<p>Let\u2019s turn to the numbers. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>According to CDC, around 1.7 million Americans develop\nsepsis each year, with about 270,000 dying from the disease annually.<sup>(3)<\/sup>\n<\/li><li>The American Heart Association states that cardiovascular disease is\nthe underlying cause of about 1 in 3 deaths (nearly 836,546 deaths) each year\nin the U.S.<sup>(4)<\/sup><\/li><\/ul>\n\n\n\n<p>So it\u2019s roughly 270,000 vs.\n836,564. That makes cardiovascular disease the clear number one killer. What\u2019s\ngoing on here? <\/p>\n\n\n\n<p>It turns out that physicians face significant\nchallenges when it\ncomes to identifying sepsis \u2013 let alone citing the life-threatening disease as\ncause of death. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>A 2016 CDC study<sup>(5)<\/sup> reveals that\nvarying \u2013 and fuzzy \u2013 estimates in sepsis-related mortality rates are frequently\ndue to a death certificate requirement. Death\ncertificates indicate a specific disease or injury that initiated a series of\nevents that led to death. This specific disease or injury becomes the\nunderlying cause of death. Because sepsis is often viewed as the final common\npathway, rather than the initial underlying cause of death, it\u2019s often omitted\nfrom the death certificate.&nbsp; <\/li><li>Many\nsepsis symptoms<sup>(6)<\/sup>, such as fever, rapid breathing, rash, heart\nrate, disorientation, and difficulty breathing, are common in other conditions\n\u2013 including heart disease <sup>(5)<\/sup>. This makes an early-stage sepsis\ndiagnosis difficult and easy to confuse with other possible diagnoses. <\/li><li>The\ncurrent definition<sup>(7)<\/sup> of sepsis remains complicated and difficult to\napply in a clinical setting. <\/li><li>Identifying\nthe best sepsis screening tools<sup>(7)<\/sup> and refining a biomarker to\ndefinitively identify patients who have sepsis remains elusive. <\/li><li>Diagnosing\nsepsis in patients with altered physiology<sup>(7)<\/sup>, such as infants or\npregnant and early postpartum women, poses yet another challenge \u2013 as clinical\nfeatures may be non-specific. <\/li><\/ul>\n\n\n\n<p><strong>A Quick Refresher<\/strong><\/p>\n\n\n\n<p>According to the AACC, sepsis occurs when there is an exaggerated reaction by the immune system to an infection, such: <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The flu<\/li><li>Pneumonia<\/li><li>Skin infection<\/li><li>Urinary tract infection<\/li><li>Infection in the bloodstream <\/li><li>Infection in the digestive system <\/li><\/ul>\n\n\n\n<p>These infections may be viral, bacterial, or fungal. <\/p>\n\n\n\n<p>Sepsis progresses to septic shock\nwhen specific changes in the circulatory system, the cells of the body, and the\nway the body utilizes energy become increasingly abnormal<sup>(8)<\/sup>. In\nsevere cases, one or moreorgans collapse. In the most critical cases,\na drop in blood pressure occurs and the heart becomes weak. It\u2019s at this point\nthat the patient begins to go into septic shock and multiple organs,<sup>(6)<\/sup>\nsuch as the lungs, kidneys, and\/or liver, may fail \u2013 leading to death. <\/p>\n\n\n\n<p>With no fast, efficient, single test<sup>(9)<\/sup> that can definitively say if a patient does or does not have sepsis, consistently diagnosing early-stage sepsis \u2013 when it\u2019s most treatable \u2013 can feel like a crapshoot. That\u2019s a darn shame, since the survival rate for patients treated during the earliest stage of sepsis is relatively high. At a later stage, which can occur within hours of disease onset, septic shock becomes an issue and the mortality rate increases by 40 to 70 percent<sup>(2)<\/sup>. <\/p>\n\n\n\n<p>That said, progress is being made. In the last two years, new tests have been implemented that may support early diagnosis and treatment for sepsis. Look out for an even closer look at this topic in next week&#8217;s part two, &#8220;A Need for Speed &#8211; New tests to help diagnose sepsis.&#8221;<\/p>\n\n\n\n<p>&#8212;<\/p>\n\n\n\n<p>Resources<\/p>\n\n\n\n<p>1)<a href=\"https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db328.htm\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" Mortality in the United States, 2017 (opens in a new tab)\"> Mortality in the United States, 2017<\/a><\/p>\n\n\n\n<p>2) <a href=\"https:\/\/www.aacc.org\/media\/press-release-archive\/2019\/01-jan\/new-tests-could-reduce-deaths-from-sepsis-which-kills-more-people-than-heart-attacks\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Sepsis Kills More People Than Heart Attacks; New Tests in AACC's The Journal of Applied Laboratory Medicine January Issue Could Help Rein In This Deadly Condition -  AACC.org  (opens in a new tab)\">Sepsis Kills More People Than Heart Attacks; New Tests in AACC&#8217;s The Journal of Applied Laboratory Medicine January Issue Could Help Rein In This Deadly Condition &#8211;  AACC.org <\/a><\/p>\n\n\n\n<p>3) <a href=\"https:\/\/www.cdc.gov\/sepsis\/datareports\/index.html \" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Data and Reports (opens in a new tab)\">Data and Reports<\/a> <\/p>\n\n\n\n<p>4) <a href=\"https:\/\/www.heart.org\/-\/media\/data-import\/downloadables\/heart-disease-and-stroke-statistics-2018---at-a-glance-ucm_498848.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Heart Disease and Stroke Statistics 2018 At-a-Glance (opens in a new tab)\">Heart Disease and Stroke Statistics 2018 At-a-Glance<\/a> <\/p>\n\n\n\n<p> 5) <a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6513a2.htm?s_cid=mm6513a2_w \" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Varying Estimates of Sepsis Mortality Using Death Certificates and Administrative Codes - United States, 1999-2014 | MMWR   (opens in a new tab)\">Varying Estimates of Sepsis Mortality Using Death Certificates and Administrative Codes &#8211; United States, 1999-2014 | MMWR  <\/a><\/p>\n\n\n\n<p>6) <a href=\"https:\/\/www.nigms.nih.gov\/education\/pages\/factsheet_sepsis.aspx \" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Sepsis  (opens in a new tab)\">Sepsis <\/a><\/p>\n\n\n\n<p>7) <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4410741\/ \" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Recognizing and managing sepsis: what needs to be done?   (opens in a new tab)\">Recognizing and managing sepsis: what needs to be done?  <\/a><\/p>\n\n\n\n<p>8) <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/sepsis\/symptoms-causes\/syc-20351214\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Sepsis - Symptoms and causes (opens in a new tab)\">Sepsis &#8211; Symptoms and causes<\/a> <\/p>\n\n\n\n<p> 9) <a href=\"https:\/\/www.sepsis.org\/sepsis\/testing-for-sepsis\/ \" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Testing for Sepsis - Sepsis Alliance (opens in a new tab)\">Testing for Sepsis &#8211; Sepsis Alliance<\/a> <\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n","protected":false},"excerpt":{"rendered":"<p>Google \u201cleading cause of death in the United States\u201d and right there in the top spot, page one, is a link to the Centers for Disease Control and Prevention (CDC), which declares heart disease the winner.(1)\u00a0 Yet, the American Association for Clinical Chemistry (AACC) passes this rank to sepsis. In its special sepsis issue of [&hellip;]<\/p>\n","protected":false},"author":29,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-22041","post","type-post","status-publish","format-standard","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/posts\/22041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/comments?post=22041"}],"version-history":[{"count":0,"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/posts\/22041\/revisions"}],"wp:attachment":[{"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/media?parent=22041"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/categories?post=22041"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medgoo.com\/index.php\/wp-json\/wp\/v2\/tags?post=22041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}