Suspected sepsis: summary of NICE guidance

nice_logoGuidelines include:

  • “Think sepsis” in any person with suspected infection

  • Sepsis may present with non-specific symptoms and signs and without fever

  • Have a high index of suspicion of sepsis in those who are aged <1 year or >75 years, pregnant, or immunocompromised, and those who have a device or line in situ or have had recent surgery

  • Use risk factors and any indicators of clinical concern to decide if full assessment is required

  • Offer people at high risk of sepsis broad spectrum antibiotics and intravenous fluids in hospital

Identify sepsis in patients by using early warning scores, doctors are urged

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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.

Critical Care Bulletin: December 2014

 

The latest Critical Care bulletin published by the Staff Library Service, East Cheshire NHS Trust is available here.  Topics listed below.

Autumn updates from AQuA

Issue: 91 & Issue 92 are now available from the AQuA Portal (click to log on and download).

aqua-logo_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

 

Sepsis-associated mortality in England

: 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

Objectives:
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.