The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defines sepsis as a ‘life-threatening organ dysfunction caused by a dysregulated host response to infection’.
Septic shock is defined as ‘a subset of sepsis in which the underlying circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than sepsis alone’. Sepsis is a clinical diagnosis, as there is no single diagnostic test. Both physiological and laboratory abnormalities may be present. Sepsis-3 eliminated the term ‘severe sepsis’, instead defining and stratifying ‘septic shock’ and ‘sepsis’ with the goal of facilitating the earlier recognition and more timely management of patients with sepsis. Sepsis presents as a spectrum of severity. Although there may be uncertainty about the diagnosis, the potential for rapid and serious deterioration in any patient with sepsis necessitates intervention whenever sepsis is a possibility1.
The Global Burden of Disease study used data from 109 million death records and 8.6 million hospital records in 195 countries and territories to estimate the burden of sepsis around the world. It found there were 49 million sepsis cases and 11 million deaths in 2017 – double previous estimates – with as many as one in five deaths worldwide related to sepsis. It was concerning that so many lives were being lost to a condition that is largely preventable. Previous estimates of the burden of sepsis in Australia were mainly those treated in intensive care units, which put the number of cases at 18,000 and deaths at 5,000. But the Global Burden of Disease study estimate now gives a more accurate picture of the size of the problem by including sepsis occurring outside of the hospital, putting the number of Australian cases at 55,000 and deaths at 8,700.
Sepsis is a time-critical medical emergency that arises when the body’s response to an infection damages its own tissues and organs. It can lead to shock, failure of multiple organs, and death if not recognized early and not treated promptly. Sepsis affects people of all ages and patients across a broad range of clinical specialties but particularly the very young, the very old and Aboriginal and Torres Strait Islander peoples. However, awareness is low with a 2016 survey finding 60 percent of Australians had not heard of sepsis and only 14 percent could name one of its symptoms.
There is a need for coordinated national approach that addresses pre-hospital and in-hospital recognition and treatment, to address the significant death and disability caused by sepsis2.