A new regulation that was inspired by the death of a young boy is proving to be effective. It requires hospitals in New York state to follow a procedure that rapidly identifies sepsis, an infection that can be deadly, and mandates quick treatment for those affected. A study analyzing the efficacy of the regulation was published in the New England Journal of Medicine and is briefly described in the following video.
Sepsis is a complication of an infection that gets out of control; it can cause tissue and organ damage and eventually death. According to the Centers for Disease Control and Prevention, sepsis can affect anyone, but it tends to impact those with weakened immune systems, chronic health conditions, or people over 65. There are over 1.5 million cases of sepsis every year, and one in five of those patients die from the complication. There is not a medical consensus on the methods that should be used to treat it.
"There is considerable controversy about how rapidly sepsis must be treated," explained one author of the new report, Dr. Christopher Seymour, an Assistant Professor in the Departments of Critical Care Medicine and Emergency Medicine at the University of Pittsburgh School of Medicine.
For this study, Seymour and co-authors analyzed data referencing almost 50,000 patients at 149 hospitals in New York state. The researchers determined that 83 percent of the hospitals were able to complete the protocol within the three hour deadline. They found that the average completion time was 1.3 hours.
The protocol was established due to "Rory's Regulations,” made law in New York in 2013. It states that hospitals must have procedures in place for the diagnosis of sepsis, whether severe or septic shock, and the rapid administration of the appropriate antibiotics. The law aims to prevent another situation like that faced by Rory Staunton, who died of sepsis in 2012.
The report found that the faster the sepsis patient receives treatment, the better the outcome; the odds that a patient would die went up four percent for each hour the protocol completion time took.
"Some question the benefit of rapid treatment with protocols, saying they can have unintended side effects and be a distraction in busy emergency departments. After reviewing the data, we can finally say that faster is better when it comes to sepsis care," Seymour concluded.
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Preventing sepsis includes having a healthy lifestyle by not smoking, and making sure appropriate vaccinations are received. Sepsis is often the result of a bacterial infection. Common microbes that can cause sepsis are Escherichia coli (E. coli), Staphylococcus aureus (staph), and some types of Streptococcus (strep).
"With the implementation of Rory's Regulations, New York State has been a leader in the fight against sepsis. Thanks to Governor Cuomo for recognizing the need for statewide evidence-based protocols and the work of the New York State Sepsis Advisory Workgroup, we have a system in place that quickly identifies sepsis cases, collects data and allows for ongoing communication with hospitals to improve care of their septic patients," commented Marcus Friedrich, M.D., M.B.A., F.A.C.P., medical director, New York State Department of Health Office of Quality and Patient Safety. "It is my hope that with this study, combined with the efforts of the New York State Health Department, other states will see that this is a model for combating and improving sepsis-related outcomes and reducing mortality rates."
Learn more about sepsis from the video.
Sources: AAAS/Eurekalert! via UPMC, New York State, CDC, NEJM
