Sepsis: The Common Cause of Death You've Never Heard Of
By Anne-Marie Botek, September 17, 2012
Charles Summerour was traveling for business when he acquired an everyday infection that almost killed him.After initially ignoring the symptoms of what turned out to be a urinary tract infection (the second most common infection in the human body), the 54-year-old journalist began to feel markedly worse as the day wore on. He sought medical attention from a doctor—who promptly sent him to the hospital.Within hours of being admitted, a sleeping Summerour's blood pressure had dropped to dangerous levels, his kidneys were failing and his body was slipping into a little-known but very deadly condition called, septic shock.What is sepsis?Caused by the immune system's over response to an infection, sepsis (also referred to as blood poisoning) is the most common cause of death in hospitalized patients in the United States. The human body is constantly bombarded by hordes of potentially infectious viruses and bacteria. Someone with a healthy immune system is usually able to fight off these microbes with little effort. But when an infection isn't quelled quickly enough, a person's immune system can kick into a dangerous state of overdrive where the body begins to injure itself in an effort to get rid of invaders. If left too long, sepsis can escalate into a fatal condition, called septic shock, which is marked by extensive tissue damage and organ failure.At least 50 percent of people who go into septic shock do not survive, according to Martin Doerfler, M.D., VP of Evidence Based Clinical Practice at North Shore Long Island Jewish Health System. Anyone can get sepsis at any age. It can start off as a practically anything—a bug bite, a blister, a sinus infection—and escalate to extreme proportions in a matter of hours.Some of the more common symptoms of sepsis include: fever, hypothermia, low blood pressure, elevated heart rate.Why have I never heard of this before?Despite the fact that it kills nearly 200,000 people in the U.S. every year, only about one-third of Americans have ever heard of sepsis.Summerour had no idea what it was that nearly ended his life until he got home from the hospital. "The doctors called it an infection. They said my immune system had become compromised, but they didn't really put a name to it," he says.The challenge lies in the ambiguous nature of the condition. "Sepsis is a very nondescript problem and it may not jump into physician's minds initially," Doerfler says.This may soon change, because sepsis cases are on the rise. Over a six-year period, the number of people hospitalized with sepsis more than doubled, according to the Department of Health and Human Services.Are seniors at greater risk?Seniors, with their aging immune systems and weaker bodies are more vulnerable to the damaging effects of sepsis.They're also more likely to be put in situations where the risk of developing an infection is increased. "The more you encounter the health care system the more you're exposed to infections." Doefler says. Any surgery, no matter how minor, increases a person's risk for becoming septic, as does the insertion of medical devices such as catheters, feeding tubes and IVs. Diabetics are more susceptible because their disease causes them to develop sores and wounds that have trouble healing and are thus more likely to become infected.Even if an elder survives a systematic attack, they are likely to suffer lasting consequences. Organ failure and amputation are some of the more common after effects of sepsis, but older adults may suffer serious cognitive consequences after wrestling with the disease.A recent University of Michigan study showed that 60 percent seniors who were hospitalized for severe sepsis experienced significant declines in physical or mental ability (sometimes both) even after they recovered from an infection.Study authors estimate that this finding translates into 20,000 new dementia cases in elderly Americans every year.Summerour's brush with sepsis left him with stage 3 kidney failure, and even though he says his experience "caused a lot of changes in my life," he knows that many people do not fare as well. It is this knowledge that convinced him to become a speaker and advocate for the Sepsis Alliance, a nationwide charity dedicated to raising awareness of the disease.How can I protect my loved one?Every hour that a person with sepsis goes without treatment, their risk of death increases by eight percent.The key to helping a loved one survive an infection is learning what to look for and not being afraid to speak up.Doefler says the symptoms of sepsis can be very nonspecific, but if your loved one has an infection of some kind and is acting abnormally confused or tired, it's probably time to go to the hospital. Common signs of infection include: fever, increased heart rate, discolored phlegm, stinky urine.He stresses that confusion is a big sign that a loved one needs immediate medical attention. A confused senior may be more resistant to going to the hospital, but if sepsis is suspected, their objections should be overruled.Once you're in the hospital, make sure you bring up your concerns about sepsis to the medical professionals taking care of the senior. Nurses and doctors aren't likely to initially suspect sepsis as the culprit, which is why both Doefler and Summerour say it's a good idea for caregivers to give to give hospital staff a nudge in that direction. "You need to advocate and speak up for those who can't speak for themselves," says Summerour, "Don't be afraid to be a little bit pushy."