Sepsis; One of the major causes of death among hospitalised patients

By Muhammad Qasim
July 21, 2019

Islamabad : Sepsis that has turned out to be as one of the major causes of death among hospitalised patients in the country is treatable if it is identified and treated quickly and in most of the cases, complete cure can be achieved with no lasting problems.

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Sepsis, a life-threatening illness that is caused by the body’s response to an infection has claimed at least 110 lives, the number that is documented in two major public sector hospitals in the federal capital in a year.

The immune system while protecting from illnesses and infections may go into overdrive and sepsis occurs when chemicals released into the bloodstream to fight the infection cause inflammation throughout the body and trigger a cascade of changes that can damage multiple organ systems, causing them to fail.

From July 2018 to June this year, as many as 73 patients died of sepsis at Pakistan Institute of Medical Sciences while 38 died of it at Polyclinic though we believe that the number of deaths is way higher as in many cases, causes of death were not properly mentioned in death records, said Consultant Intensive Care Medicine at PIMS Dr Muhammad Haroon while talking to ‘The News’ on Saturday.

He added that majority of people reaching hospitals after accidents are treated well by surgery but later, they die of sepsis. Doctors, nurses, paramedics and family members should practice sterilization techniques like scrubbing, hand wash etc. to avoid infections among patients, he said.

Sepsis is one of the oldest diseases among humans, however, over centuries and decades, the treatment of sepsis has revolutionized and once untreatable sepsis is now treated with modern antibiotics, fluids and medicines that improve organ functions and organ support with state-of-the-art monitoring, he said.

He however added that by far, sepsis is one of the most under-diagnosed diseases in Pakistan. The causes for sepsis are infections of skin, soft tissues, lungs, liver, GI tract, urine and brain, he said.

Studies reveal that there are three stages of sepsis including sepsis, severe sepsis, and septic shock. Symptoms of sepsis include a fever above 101ºF (38ºC) or a temperature below 96.8ºF (36ºC), heart rate higher than 90 beats per minute, breathing rate higher than 20 breaths per minute and a probable or confirmed infection.

Severe sepsis occurs when there is an organ failure and one must have one or more of the signs including patches of discoloured skin, decreased urination, changes in mental ability, low platelet count, breathing problems and abnormal heart functions, chills due to fall in body temperature, unconsciousness and extreme weakness.

Dr. Haroon said the symptoms of septic shock include the symptoms of severe sepsis along with a very low blood pressure. Most people recover from mild sepsis, but the average mortality rate for septic shock is over 40 per cent.

He added certain people with an infection are more prone to get sepsis including people aged over 65 years, infants and those who have weakened immune systems due to chronic medical conditions like diabetes.

Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival, he said.

He said like all major diseases, sepsis is treatable in initial ‘golden hours’. After organ failure or septic shock, chances of recovery decrease. The biggest issue is the awareness about sepsis and its timely recognition. Hospital acquired infections are a common source of sepsis and multi-organ failure. It can be prevented by simple measures like hand washing, sterilisation and disinfection. People in the intensive care unit are especially vulnerable to developing infections, which can lead to sepsis. If you get an infection or if you develop signs and symptoms of sepsis after surgery, hospitalisation or an infection, you must seek medical care immediately, said Dr. Haroon.

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