‘Extraordinary killer’ sepsis kills one in five patients

One in five patients who develop sepsis dies from the condition despite efforts to reduce mortality rates in Ireland by 30 per cent over five years.

Data on the illness, a serious complication of an infection, published on Tuesday showed that last year more than 14,000 cases were documented, a 67 per cent increase on 2015. Irish health officials said this trend illustrates a growing understanding and ability to combat the illness.

"We know in this country the significant learning that has taken place since the very sad death of Savita Halappanavar, " Minister for Health Simon Harris said at the publication of the 2016 National Sepsis Report.

Ms Halappanavar’s death from the condition in 2012 did much to help shape a greater public perception, and since then efforts have been made to increase medical vigilance.

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Sepsis is a condition triggered by infection, leading to organ malfunction and failure. It is the tenth biggest cause of death in the world yet has no single test to confirm its presence. Even in cases where doctors intervene quickly, patients can die.

“Sepsis is an extraordinary killer. It is a serial killer, and it is an extraordinary danger to so many people,” Mr Harris said, acknowledging Ireland’s near 20 per cent mortality rate was still relatively high despite improvements in the system.

A National Sepsis Programme in Irish healthcare was implemented in 2015. Tuesday’s annual outcome report was the second of its kind published to monitor how the threat is managed and treated.

At the report unveiling, the HSE's national clinical lead for sepsis, Dr Vida Hamilton, said there was a 67 per cent increase in the documentation of sepsis cases over the past two years, a direct result of the awareness campaign around it.

Greater awareness of the condition has come through medical training and by delivering presentations directly to acute hospitals.

“What we look at is trends. Sepsis diagnosis is extremely difficult because each presentation is unique to the individual patient,” Dr Hamilton said.

“It depends on the type of infection that they have; it also depends on the immune status of the individual patient and what their other general health co-morbidities are.”

Dr Hamilton conceded there was a potential for the overprescribing of antibiotics but that systems were in place to identify those who needed them.

She said Ireland’s 20 per cent mortality rate “benchmarks very favourably with international published literature with other high-income countries . . . so compared with the Scottish, the UK, the German, the American, or the Australian mortality rates, we compare very well.”

The report notes sepsis affects 3.4 per cent of hospital inpatients and contributes to 25 per cent of in-hospital deaths, occupying more than 300,000 bed days.

The Irish maternal sepsis-associated hospital mortality rate was zero, while the paediatric rate was 3.5 per cent.

It recommends making a sepsis e-learning programme mandatory for hospital doctors and nurses, and appointing healthcare professionals with dedicated time to support sepsis quality improvement in acute hospitals.