The Bad News on Sepsis is Really Good News
The debunking of a standard protocol for treating sepsis should not mask the great progress hospitals and clinicians have made over the last dozen years—or reduce the focus on sepsis.
This week's plot twist in the story about how hospitals deal with patients diagnosed with sepsis and septic shock may seem to many clinicians like more bad news: A protocol embedded in a nationally endorsed practice guideline didn't work better at saving lives than letting physicians use their best judgment.
True, most agree that there are problems with parts of that protocol, and the National Quality Forum and the New York State Department of Health, which is enacting reporting regulations throughout that state's hospitals, will have to go back to the drawing board.
But this is hardly cause for gloom. In fact, it is actually great news because it starts to clear the air, enabling us to see a better pathway to manage this terrible form of infection, a syndrome so thoroughly awful that the 750,000 to 1.1 million patients in the U.S. who are diagnosed with it each year are often said to be "circling the drain" because of sepsis' rapid corkscrew cascade.
And, by the way, sepsis costs the healthcare system in this country an estimated $17 billion a year because of added stays in intensive care and multiple desperation strategies to salvage failing organs.
This study, published online in the New England Journal of Medicine on Tuesday, will surely help clinicians improve their recognition and management of sepsis, which is hard to see early and extremely difficult to manage late.