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Spokane appears to have cluster of sepsis patients

Thu., June 28, 2012

Trend motivates hospital doctors and staffs to be more alert of deadly condition

Hospitals are struggling to stop a killer.

Sepsis, the body’s last resort against infection, is commonly referred to as blood poisoning as the body overreacts to an infection in ways that can shut down organs in a matter of hours.

The overreaction can be due to something as serious as an infection from pneumonia or as small as an abscessed tooth.

During the past decade, the number of patients in Washington diagnosed with sepsis has grown threefold, according to a state report issued this month. In Washington, 14 percent of sepsis patients died. That’s more than 3,000 every year. And in some areas, including Spokane, there appears to be a cluster of sepsis patients.

The troubling trends have spurred hospital doctors to draw up battle plans to ensure staffs are on the watch for patients exhibiting warning signs.

“Just by raising awareness, when sepsis is identified, it kicks everyone into high gear,” said Dr. Jeffrey Liles, the lead hospitalist at Providence Sacred Heart Medical Center.

The sepsis protocol, put into place during the past few years, is saving lives and shortening stays at the hospital.

An internal report for Sacred Heart and sister hospital Holy Family shows that patients with sepsis are receiving antibiotics within 69 minutes upon arrival at the hospital. That’s quicker than the three hours it used to take. And the treatment is shaving an average of about 2 ½ days from a patient’s hospital stay.

Liles said he believes the hospitals’ aggressive protocols that identify sepsis as the primary diagnosis requiring hospitalization is a big reason that Spokane was highlighted as among six sepsis clusters in Washington.

Joe Campo, a health care research analyst for the Washington State Office of Financial Management, said that explanation is plausible. But it’s difficult to extrapolate such conclusions from hospital patient data.

“Some communities are at higher risk than others,” Campo wrote in his research brief published this month. He even looked at patients’ residential ZIP codes, and not their place of hospitalization, when puzzling over sepsis rates for his report. The clusters are in Everett, Bremerton, Vancouver and most of Grays Harbor County. The cluster is not as serious in Spokane and parts of Lewis and Cowlitz counties, but the numbers were still high enough to draw Campo’s attention.

Sepsis is difficult to address. It is not an infectious disease, and there are no vaccines that public health officials and physicians can offer.

What matters most is time. If the appropriate antibiotics are administered to stop the infection, the body’s own toxic reaction might be lessened, preventing further damage.

The Centers for Disease Control issued a report last year noting that the rising number of sepsis patients may be attributed to an aging population with more chronic illnesses; the frequency of invasive procedures; and greater use of immunosuppressive drugs, chemotherapy and organ transplantation.

The most common signs of sepsis include high fever, rapid heart rate, fast breathing, dropping blood pressure, confusion and low urine levels.



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