Sepsis death rate rises again after falling for a decade

One in five patients who develop sepsis dies from the condition, and mortality rates are on the rise again after falling for almost a decade, a new report shows.

The HSE’s 2018 Sepsis Report shows the mortality rate up 10.1 per cent last year, from 17.6 per cent in 2017 to 19.4 per cent in 2018.

Earlier this year the HSE won an international award for its efforts to tackle sepsis after showing it had cut the death rate from the condition by 5 percentage points.

However, the 2018 report shows the number of cases detected in Ireland’s health system fell to 14,639, an 11.7 per cent decrease.

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The report suggests the trends of falling incidence and rising mortality rates may be driven by a change in definition of the condition that has led to fewer people, with more serious cases, being coded as having sepsis.

The condition places a major burden on the health system, with the average patients with sepsis spending 21.9 days in hospital.

There has been an increased focus on the condition since Savita Halappanavar’s death in 2012, which did much to increase public awareness and the need for great vigilance in the health service.

No one test

Sepsis is triggered by infection, leading to organ malfunction and failure. It is the 10th-biggest cause of death in the world, yet no single test can confirm its presence. Even in cases where doctors intervene quickly, patients can die.

Symptoms can include slurred speech, excessive drowsiness, muscle or joint pain, severe breathlessness and pale or discoloured skin.

"The most effective way to reduce mortality from sepsis is by prevention, good sanitation, personal hygiene, eating healthily and exercising moderately, breastfeeding, avoiding unnecessary antibiotics and vaccination for vaccine preventable infections," Dr Martina Healy, national sepsis lead for the HSE, writes in the report.

“The next most effective way is early recognition and treatment. This is not simple. Sepsis evolves over time and the pattern of evolution is extremely variable as it depends on the patient’s general health status, their genetic response to infection and the characteristics of the infecting microbe.”

The report is usually published at a national sepsis summit held in Dublin each autumn, but publication of the 2018 report was delayed.