Introduction
Sepsis- the life-threatening response of the body to an infection- is one of the more common reasons for presentation to an Acute Medical Unit, and a major health and economic burden to our healthcare system, with an estimated 37,000 deaths occurring annually in the U.K. In the United States, recent evidence suggests that the incidence of sepsis has been rising by between 8 and 13% per annum over the last decade, and that it is now higher than that of Acute Coronary Syndrome.1 Across Europe, the cost of a hospital admission for sepsis (due to the frequent need for prolonged Critical Care admission) has been estimated at between 25,000 and 55,000 Euros.2 For the NHS, this means an estimated expenditure of £2.5 billion per year.
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References
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- Hyattsville, MD: National Center for Health Statistics. 2011.
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- Levy MM, Dellinger RP, Townsend SR et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Critical Care Medicine 2010; 38: 1–8 .
- College of Emergency Medicine Clinical Audits: Severe sepsis and septic shock, 2012. Available online at http://www.collemergencymed. ac.uk/Shop%2DFloor/Clinical%20Audit/Previous%20Audits/
- Cronshaw HL, Daniels R, Bleetman A, et al. Impact of the Surviving Sepsis Campaign on the recognition and management of severe sepsis in the emergency department: are we failing? Emergency Medicine Journal 2011; 28(8): 670-5.
- Levy MM, Artigas A, Phillips GS, et al. Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: a prospective cohort study. The Lancet Infectious Diseases 2012; (published online ahead of print).
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- McNeill G, Dixon M, Jenkins P. Can acute medicine units in the UK comply with the Surviving Sepsis Campaign’s six-hour care bundle? Clinical Medicine, Journal of the Royal College of Physicians 2008; 8(2): 163-5.
- Kumar A, Roberts D, Wood KE, et al. Duration of hypotension prior to initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical Care Medicine 2006; 34: 1589–96.
- Gaieski DF, Mikkelsen ME, Band RA, et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Critical Care Medicine 2010; 38: 1045–53.
- Castellanos-Ortega A, Suberviola B, García-Astudillo LA, et al. Impact of the Surviving Sepsis Campaign protocols on hospital length of stay and mortality in septic shock patients: results of a three-year follow-up quasi-experimental study. Critical Care Medicine 2010; 38(4): 1036-43.
- Shorr AF, Micek ST, Welch EC, et al. Inappropriate antibiotic therapy in Gram-negative sepsis increases hospital length of stay. Critical Care Medicine 2011; 39(1): 46-51.
- Davydow DS, Gifford JM, Desai SV, et al. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. General Hospital Psychiatry 2008; 30: 421-34.
- Iwashyna TJ, Ely EW, Smith DM, et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 2010; 304: 1787-94.
- Bagshaw SM, Lapinsky S, Dial S, et al. Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy. Intensive Care Medicine 2009; 35(5): 871-81.
