Sepsis – a growing medical and economic burden

12 September 2013

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Image from World-Sepsis-Day.org. Licenced under Creative Commons.

Sepsis has been described as one of the most common but least recognised illnesses in both the developed and developing world. It is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. If not recognised early and treated promptly, sepsis can lead to multiple organ failure and death.

  • Sepsis accounts for around 37,000 deaths per year in the UK alone, with an estimated 1,800 of those to be in Wales. It claims more lives than lung cancer, and more lives than breast cancer and bowel cancer combined.
  • Severe sepsis has a mortality rate of around 30 to 50 per cent. Rapid intervention with antibiotics and intravenous fluids is vital to ensure best chance of survival.
  • According to the UK Sepsis Trust, patients with sepsis occupy over 30 per cent of intensive care beds in UK hospitals, and the condition costs the NHS over £2.5 billion annually. For Wales, this equates to a cost of around £125 million.
  • It is one of the chief causes of maternal death during and after pregnancy.
  • In the developed world, sepsis has been increasing annually at a rate of 8 – 13 per cent. This has been linked to the aging population, greater use of high-risk interventions in all age groups, and the development of antibiotic-resistant and more virulent varieties of infections.

Some of the measures adopted by NHS Wales organisations to tackle sepsis include:

  • the National Early Warning Score, a simple system hospital staff use to assess whether patients are developing potentially life-threatening illnesses;
  • sepsis screening tools, which help identify sepsis in patients at very early stages, meaning life-saving treatment can be given much earlier;
  • the ‘sepsis six’ care bundle which consists of three quick tests for sepsis and three simple treatments to combat it, and;
  • the Rapid Response to Acute Illness programme (RRAILS).

The Welsh Government’s Delivery Plan for the Critically Ill states that Local Health Boards should ensure that all acutely unwell patients are screened for sepsis and that the appropriate care pathway is delivered where indicated. RRAILS and the sepsis six approach should be rolled out in each acute site of the Local Health Boards.

Concerns remain however, about the lack of awareness of sepsis among healthcare professionals, as well as among the general public, which may result in patients presenting late with symptoms, or early signs of the illness being missed. Assembly Members may be aware of the Public Services Ombudsman for Wales’ recent report of its investigation of a complaint against Hywel Dda Health Board, in relation to the death of a patient from sepsis which an out-of-hours GP had failed to diagnose.

Friday 13 September 2013 is World Sepsis Day, of which a major goal is improved public and professional understanding and awareness of sepsis.

Article written by Philippa Watkins.