Date: October 10th, 2013
Every year as many as one million Americans develop sepsis—a life-threatening medical condition that arises when the body initiates a powerful immune response against an infection. All types of infection can lead to sepsis—from an infected scrape, to pneumonia, to an infection at a surgical incision site, and no matter what the origin, sepsis can lead to death. Sepsis is the 10th leading cause of death in the U.S. and up to 40% of patients do not survive.
Anyone can get sepsis and die of it, but it disproportionately impacts older Americans, with two-thirds of all cases occurring in individuals age 65 and older. With age often comes weakened immune systems, the need for more surgeries, skin ulcers or bed sores from thinner skin, chronic diseases such as diabetes and cancer, autoimmune disorders, and malnutrition—all of which make seniors more vulnerable to sepsis.
Stopping It in Time
Our bodies face intrusions from microbes like bacteria, viruses, parasites, and funguses all the time and our immune systems react by targeting the invaders with a tempered, appropriate response. However, in sepsis, the body overeacts and triggers a cascade of chemical messengers that cause inflammation within blood vessel linings. As the inflammation becomes widespread, blood clotting results and can slow down oxygen and nutrient delivery throughout the body. This can lead to organ dysfunction and failure.
While experts don’t yet know why the body overreacts, they do know that the best bet for survival is early detection. Recognizing the signs of sepsis is the first step in fighting back. Common symptoms include a fever, rapid heart rate, and rapid breathing. If an organ is affected as the primary site of infection, as with the lungs in pneumonia, the person may also experience shortness of breath, painful coughing, or discolored mucous. With older patients, the symptoms may present differently. A fever may be absent—in fact the opposite can occur with cold, clammy skin. They are also more likely to have sudden mental confusion or delirium, fatigue, malaise, weakness, sudden shortness of breath, poor appetite, chills, dizziness, and low blood pressure.
If any of these symptoms exist at the same time as fever, it’s time to get help. And remember that there’s not a lot of time. While not all infections develop into sepsis, those that do can progress from a localized infection to out-of-control sepsis within mere hours. The longer the infection rages, the less likely a person is to survive. For every hour delay in appropriate treatment, the risk of death increases by eight percent.
A physician may diagnosis sepsis based on the presence of some of the symptoms above, but they may also confirm with blood tests, a chest x-ray, or a CT scan. Treatment for sepsis usually involves hospitalization and admission to the intensive care unit (ICU). People over the age of 85 are about 30 times more likely to end up hospitalized than people younger than 65. Older adults who are admitted to the ICU are generally sicker, and require longer lengths of stay.
Doctors are not able to stop the intense immune response seen in sepsis but instead target the infection itself. Treatment usually involves broad-spectrum antibiotics that can kill a wide variety of bacteria. Lab tests may be able to identify the specific infection and better target the medications. Most patients receive oxygen and IV fluids in an attempt to keep oxygen and blood pressure levels as close to normal as possible. If the infection has progressed and the organs are involved, the patient may need ventilation for the lungs, dialysis for the kidneys, etc. They may also need surgery to clear out infected tissues.
Those that survive are not always out of the woods. Post-sepsis-syndrome (PSS) affects as many as half of all sepsis survivors and leaves them with often long-term effects such as:
- Insomnia, difficulty getting to sleep or staying asleep
- Nightmares, vivid hallucinations, and panic attacks
- Disabling muscle and joint pains
- Extreme fatigue
- Poor concentration
- Decreased mental (cognitive) functioning
- Loss of self-esteem and self-belief
The more time spent in the hospital and ICU for treatment, the more likely an individual will develop PSS. And the older the survivor, the higher the risk for cognitive impairment and physical problems. So even though they’re alive, their ability to live independently and in good health is often robbed of them.
Spreading the Word
While researchers continue to look for answers that will lead to better prevention and treatment, the Alliance for Aging Research is helping spread the word about this deadly, but largely unknown, condition. This Fall, the Alliance released a “pocket film” aimed at raising awareness of the signs, symptoms, and urgency of sepsis. This short and shareable film is available on YouTube and is meant to be shared with family members, friends and loved ones. By spreading the word and increasing early recognition, we can save lives.