Beware Sepsis – Think Sepsis

Sepsis continues to be a leading cause of death in the UK and a significant burden on the UK health system. Awareness, knowledge and recognition of the condition is still problematic among many healthcare professionals and the public.

Sepsis is a preventable, debilitating, life-threatening, and costly condition that poses a persistent challenge to clinicians in terms of early diagnosis and management.

It arises when the body’s response to an infection injures its own tissues and organs. Sepsis may lead to shock, multiple organ failure and ultimately death if not recognised early and treated promptly.

Prevalence and cost of sepsis

According to the UK Sepsis Trust, every year in the UK, there are at least 245,000 episodes of sepsis, with up to 48,000 people dying as a result. Sepsis claims more lives than breast, bowel and prostate cancer combined. In addition, patients who survive sepsis often suffer long term physical and mental problems, such as post-traumatic stress disorder, cognitive problems, chronic pain and organ dysfunction.

In England, ‘Hospital Episode Statistics (HES)’ highlighted that the incidence of sepsis is rising by approximately 11.5% each year. The UK Sepsis Trust state: “The increase in recorded incidence of sepsis will be in part due to heightened awareness and more reliable recording, but our ageing populations and increasing tendency to perform a greater number of invasive interventions will have a significant effect. Antimicrobial resistance may play a small, but ever-growing part.”

At Premium Medical Protection, we are focused on supporting customers to reduce their risk profile and in so doing, enhancing the safety of patients. Given the sobering facts surrounding the prevalence of sepsis and the significant burden on patients, we believe this is an important area to highlight.

Delay in diagnosing sepsis

Various factors may contribute to a lack of sepsis awareness and delays in diagnosis.

1. The terms and definitions associated with sepsis have changed over the years, and the lack of standardisation has led to multiple definitions in use at the same time. Additionally, identification criteria associated with the terminology and definitions have varied.
2. The early signs and symptoms of sepsis are indicative of a variety of other illnesses and conditions and the progression of the condition can vary based on the site of infection, the pathogen and individual factors. Therefore, sepsis can present like many other conditions and can manifest in very different ways from patient to patient.
3. A treatment delay of just six hours worsens the prognosis, and the risk of mortality increases 7.6 percent each hour that antimicrobial treatment is delayed. Hence, early detection and appropriate management of sepsis is key to achieving successful outcomes.

NICE guidance

In January 2024, NICE updated its NG51 guideline for the UK originally published in 2016. The updates predominantly centred around the use of the National Early Warning Score (NEWS2) and recommendations around the timing of antibiotics made by the Academy of Medical Royal Colleges in 2022. NICE provide a selection of resources and tools for the recognition, diagnosis and early management of sepsis.

In summary

Sepsis continues to have a significant impact on patient outcomes and the resilience and wellbeing of clinicians. The importance of continuing to increase awareness and understanding of the condition can hardly be overstated.

Clinicians should consider implementing risk management strategies to increase understanding about sepsis and promote early recognition and action. This may ultimately save lives and reduce the costly burden on the healthcare system.

If you are involved in a patient safety incident or receive a complaint from a patient, please call the PMP medicolegal helpline as soon as possible, in line with the terms and conditions of your policy. The PMP medicolegal helpline is available to customers 24/7. The contact details are in your policy documents, or you can access the helpline through the PMP WebApp.