What is sepsis? – Q&A with an expert

Diane Kantaros, MD
Chief Quality Officer for Nuvance Health
Sepsis Committee Chair, Vassar Brothers Medical Center
Associate Vice President of Medical Affairs, Quality Systems

Q: What is sepsis and why do I hear about it in the news so much?

A: Sepsis is an overwhelming infectious syndrome that has the potential to damage your body's vital organs and at times lead to death. In the past 5 years, organizations such as the The Rory Staunton Foundation and The Surviving Sepsis Campaign have raised awareness of this syndrome worldwide. Rory Staunton was a 12-year-old child who was misdiagnosed in a New York City emergency room and sent home with Tylenol. He later returned to the hospital in septic shock and died. The Staunton family courageously turned their grief into a worldwide campaign to diagnose and treat the early signs and symptoms of sepsis aggressively.

Q: Who can get sepsis and what kind of infections can cause sepsis?

A: Anyone can get sepsis. However, some people are more vulnerable than others. Those with weakened immune systems from steroids, diabetes, old age, chemotherapy and even the young are more susceptible to sepsis, but anyone can get it given the right circumstances. Likewise, any infection has the potential to cause sepsis. If a local infection spreads, for example, an infection in your kidney moves into the bloodstream, then your risk of sepsis increases dramatically.

Q: What are some signs or symptoms of sepsis I should look out for?

There is no one sign or symptom for sepsis, but in general, a patient with severe sepsis or septic shock may have labored breathing, confusion, decreased urination, increased thirst, decreased blood pressure or a rapid heart rate. They may sweat or shake from fever. A patient may have one, none, or all of these symptoms. Sometimes the medicines we take may mask some of the symptoms. Other times, a young, healthy person may compensate and look good on the outside while their vitals and labs tell a different story. As healthcare providers, we really want to see our community members before they reach this point. So my advice would be, if you have an infection that doesn't feel like it is going in the right direction, if it is worse than any prior experience you have had or you aren't sure what is going on, get checked out by a healthcare professional early.

Q: What has changed in diagnosing sepsis?

Since 2012, when Rory Staunton was misdiagnosed, the Staunton family has worked closely with Gov. Andrew Cuomo and the surviving sepsis campaign to enable the Department of Health to track and monitor early detection and early treatment of sepsis in all New York state hospitals. This has resulted in an overall decrease in mortality across the state in septic patients. Vassar Brothers Medical Center has been designated a "high performer" in sepsis treatment by the Department of Health because of its low mortality rates, meaning we are saving lives by diagnosing and treating sepsis early.

Q: It is great to hear that Vassar Brothers compares well in New York state. How does it compare nationally in the treatment of sepsis?

A: We always compare our medical center to other like hospitals with a goal of being a top performer in the country. Our mortality rates have dropped every year for the past five years and we just presented our sepsis initiatives at the National Association for Healthcare Quality convention in Ohio. It was humbling to share our unique initiatives at the national level. We really enjoyed the dialogue around sepsis with various institutions represented around the country.

Q: How has Vassar Brothers Medical Center been able to achieve this reduction in mortality in sepsis?

A: The sepsis committee has been meeting monthly since 2013. This is truly a multidisciplinary committee approach toward treating this syndrome. We started with ensuring compliance with all recommendations for early diagnosis and treatment bundles, but we have expanded the discussion to preventable complications that lead to sepsis and complications that result from sepsis. Every part of our hospital is involved in this effort, from the ICU, the Emergency Department and the hospitalist physicians to the cleaning staff, patient safety techs, lab services and the IT department. There is no one fix. We are always reviewing for areas to improve on. At this time, we are getting ready for the flu season and have started implementing a plan to get ahead of this potentially fatal disease before the season event starts. You can help by getting your flu shot. In addition to prevention with a vaccine program, we are working with new technology for faster testing, diagnosis, isolation and treatment of the flu in our ERs.

Dr. Kantaros, thank you for your time and insight on this topic. It is enlightening to know just how much time and effort all of the members of VBMC puts into reducing sepsis mortality.