Strict guidelines reduce sepsis-infection deaths in hospitals, Utah study shows

SALT LAKE CITY — Research at two Utah hospitals indicates using a specific set of standards to treat serious infections can greatly reduce the number of patients who die from them, according to a new study.

The report on research conducted at Intermountain Medical Center and LDS Hospital indicated that strict treatment guidelines could dramatically reduce the number of deaths associated with sepsis and septic shock — up to 80 percent over some hospitals.

Sepsis is a severe illness in which bacteria from an infection overwhelm the bloodstream. It often begins as an ordinary infection, such as pneumonia or a urinary tract infection.

About 500,000 patients nationwide are treated for sepsis each year. Delayed or inconsistent treatment plans can increase the risk of dying from sepsis to alarmingly high levels, a news release stated.

Using an 11-element approach or bundle, the number of sepsis-related deaths was lowered to 10.3 percent of patients — a decline of nearly 80 percent compared to some national averages.

"The bundle involved … 11 items that (hospitals) would try to deliver as a recipe to treat … in this case, sepsis," Dr. Todd Allen, lead researcher and emergency medicine physician at Intermountain Medical Center and LDS Hospital told the Deseret News. The bundle elements included using blood tests and cultures, giving patients antibiotics and a fluid regimen, he added.

Allen said treating patients with sepsis aggressively and at a much earlier stage were key elements in achieving the improved results.

The findings will be presented Saturday at the Society for Academic Emergency Medicine's annual conference in Phoenix and will also be published in the June edition of the journal Academic Emergency Medicine.

"Physicians have always struggled with sepsis, and once someone gets to the septic shock stage, mortality rates are alarmingly high," Allen said. "But we've been able to reduce sepsis-related deaths to a remarkably low level."

Over a six-year span, researchers looked at approximately 1,000 patients who arrived at one of the two hospitals' emergency rooms with severe sepsis or septic shock, and who were also over age 18 and not pregnant. Using the complete protocol bundle, deaths dropped from 18 percent to 10.3 percent, Allen said.

In the wake of the research, 10 of Intermountain Healthcare's hospitals — those capable of providing the acute care sepsis patients require — have committed to using the sepsis bundle to reduce deaths.

Before the discovery of penicillin, sepsis was the No. 1 cause of death in the world. Today, it's still the second-leading cause of death among patients in the non-coronary intensive care unit and the 10th-leading cause of death in the United States, a news release stated.

"If other hospitals follow Intermountain's example, we may see that statistic fall even more," Allen said.

e-mail: jlee@desnews.com