University of Pittsburgh Graduate School of Public Health researchers played a central role in a worldwide effort to redefine a major public health threat and the leading killer of hospital patients: sepsis.
In a series of articles published in the Journal of the American Medical Association, an international task force updated definitions of sepsis and septic shock, which were last revised in 2001. These new definitions help bring clarity to sepsis, a syndrome that is difficult for doctors to diagnose and deadly for patients. The task force definitions were directly informed by research out of the Clinical Research, Investigation, and Systems Modeling of Acute illness (CRISMA) Center at the Pittsburgh School of Medicine and were funded in part by grants from the National Institutes of Health.
In accompanying articles published in the journal Critical Care Medicine, Pittsburgh scientists also present a conceptual framework to help patients, clinicians, researchers and hospitals apply the new definitions. The results were presented at the Society of Critical Care Medicine’s annual meeting in Orlando, Florida.
Sepsis is a condition that arises when the body’s response to an infection injures its own tissues and organs, sometimes progressing to septic shock. It may occur in up to two million U.S. patients every year, and, despite best practice, more than one in 10 sepsis patients do not survive.
“Considerable advances have been made in the study and care of sepsis and septic shock in the past 15 years, and there is an urgent need to help the medical community do a better job identifying septic patients quickly and start life-saving treatment,” said Dr. Derek C. Angus, the Dr. Mitchell P. Fink Professor and chair of Pittsburgh’s department of critical care medicine and professor of health policy at Pittsburgh. “Put simply, sepsis is a life-threatening organ dysfunction due to a dysregulated response of the patient’s immune system to infection. Our intent is that this definition results in greater consistency for epidemiologic studies, clinical trials and – perhaps most important – better recognition and more timely management of patients with, or at risk of developing, sepsis.”
Two years ago, the European Society of Intensive Care Medicine and the Society of Critical Care Medicine convened a task force of 19 critical care, infectious disease, surgical and pulmonary specialists. They noted considerable advances in the pathophysiology, management and epidemiology of sepsis, suggesting a need for re-examination of the definition.
The new criteria include the “quick Sepsis-related Organ Failure Assessment,” or qSOFA, to help clinicians diagnose septic patients and get treatment started outside the intensive care unit. It uses only three symptoms: altered mental status, fast respiratory rate and low blood pressure, and does not require blood tests. If patients with infection show two of the three criteria, they should be considered likely to be septic. Such patients account for more than three out of four infection-related deaths. The qSOFA prompt was developed by analyzing more than 800,000 electronic health record encounters at 177 hospitals worldwide, including academic, community, public, private, and federal hospitals.
For the complete multimedia press release visit http://www.upmc.com/media/NewsReleases/2016/Pages/pitt-upmc-redefine-sepsis.aspx.
For the JAMA sepsis package visit http://jamasepsis.com/