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General practitioners and hospital doctors should all use an early warning score system when they suspect that a patient may have sepsis to help improve the recognition of cases, a report recommends.
Nearly half (45%) of patients with sepsis admitted to hospital with no other obvious problem either died or were left with a disability, an audit of cases in England, Wales, and Northern Ireland has found.
In this monthly alert from BMJ Best Practice there are 2 new topics.
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- Heparin-induced thrombocytopenia
- Sepsis in children
Issue: 91 & Issue 92 are now available from the AQuA Portal (click to log on and download).
Issue 91 – sample content includes:
- The 2015 Challenge Manifesto: a time for action
- A new settlement for health and social care
- NHS England Chief Executive committed to improving dementia diagnosis
- Horizon Scanning – CMO
- Patient Experience – personalised’ mental health resource
- Horizon Scanning
- Safer Care – treatment of sepsis
- Integration – joined-up care for people with complex needs
- Safer Care – CQC inspects independent hospitals
In Issue 92 you’ll find the Top Stories:
- New MyNHS transparency site goes live
- NHS England publishes Annual Review
- FTs under pressure, analysis shows
- Reducing Mortality
- Patient Experience – cancer patients’ experience
: an analysis of multiple cause of death data from 2001 to 2010
Duncan McPherson1 Clare Griffiths Matthew Williams Allan Baker
Ed Klodawski Bobbie Jacobson Liam Donaldson
To quantify mortality associated with sepsis in the whole population of England.
Design: Descriptive statistics of multiple cause of death data.
Setting: England between 2001 and 2010.
Participants: All people whose death was registered in England between 2001 and 2010 and whose certificate contained a sepsis-associated International Classification of Diseases, 10th Revision (ICD-10) code.
Data sources: Multiple cause of death data extracted from Office for National Statistics mortality database.
Statistical methods: Age-specific and sex-specific death rates and direct age-standardised death rates.
Results: In 2010, 5.1% of deaths in England were definitely associated with sepsis. Adding those that may be associated with sepsis increases this figure to 7.7% of all deaths. Only 8.6% of deaths definitely associated with sepsis in 2010 had a sepsis-related condition as the underlying cause of death. 99% of deaths definitely associated with sepsis have one of the three ICD-10 codes—A40, A41 and P36—in at least one position on the death certificate. 7% of deaths definitely associated with sepsis in 2001–2010 did not occur in hospital.
Conclusions: Sepsis is a major public health problem in England. In attempting to tackle the problem of sepsis, it is not sufficient to rely on hospital-based statistics, or methods of intervention, alone. A robust estimate of the burden of sepsis-associated mortality in England can be made by identifying deaths with one of the three ICD-10 codes in multiple cause of death data. These three codes could be used for future monitoring of the burden of sepsis-associated mortality.
Mechanical thrombectomy of an infected deep venous thrombosis: a novel technique of source control in sepsis – published in British Journal of Anaesthesia, January 2011, vol./is. 106/1(65-8), 0007-0912;1471-6771 (2011 Jan)