Subtle changes may point to greater risk of sepsis death, study finds

The symptoms that place patients at the greatest risk of dying from sepsis may not be what many clinicians think they are, a study published in Critical Care found.

The study, conducted by researchers at Philadelphia-based Drexel University, looked at data from 210,289 hospital visits between July 2013 and April 2016. The researchers found treating patients for an infection within 24 hours of hospitalization significantly lowered their risk of dying. They also found impaired kidney function is one of the leading predictors of sepsis patient mortality.

"We now have large-scale evidence that many of these organ system failures that are typically underappreciated — particularly the renal and respiratory systems — actually have the highest association with death," said study co-principal investigator Ryan Arnold, MD. "That means that symptoms related to these systems need to be raising a red flag for doctors. We're saying, 'Hey, this is the type of patient you need to be paying more attention to.'"

The more well-known sepsis symptoms, including low blood pressure, were associated with lower mortality rates in the patients the researchers studied.  

"[This finding] likely speaks more to the healthcare providers' response to the symptom, than the low blood pressure itself actually being a protective factor," Dr. Arnold said. "With sepsis, patients generally don't fall off of a cliff. Instead, it's a day by day, gradual deterioration. Those subtle changes that don't get detected, we found, lead to death."

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