Emergency surgery, co-existing illness, age over 60 linked to deadly blood infection, study found
TUESDAY, July 20 (HealthDay News) -- General surgery patients in the United States are more likely to suffer from life-threatening sepsis and septic shock than heart attacks or blood clots in the lungs, researchers have found.
Their study, published in the July issue of the Archives of Surgery, also found that about one-third of patients who develop septic shock after general surgery die within 30 days of the operation.
Sepsis -- known colloquially as blood poisoning -- is a dangerous and potentially lethal body-wide inflammatory response to an infection. Usually caused by bacteria in the bloodstream, sepsis can lead to septic shock, followed by multiple organ failure and death.
In the study, researchers reviewed national data from 363,897 patients who had general surgery between 2005 and 2007. Sepsis occurred in 8,350 (2.3 percent), septic shock occurred in 5,977 (1.6 percent), blood clots in the lungs (pulmonary embolism) occurred in 1,078 (0.3 percent), and heart attack occurred in 615 (0.2 percent).
Within 30 days after surgery, death rates for each of the serious complications were as follows: 5.4 percent for sepsis, 33.7 percent for septic shock, 9.1 percent for blood clots in the lungs, and 32 percent for heart attack.
"Of note, septic shock occurs 10 times more frequently than [heart attack] and has the same mortality rate; thus, it kills 10 times more people. Therefore, our level of vigilance in identifying sepsis and septic shock needs to mimic, if not surpass, our vigilance for identifying [heart attacks and blood clots in the lungs]," wrote Dr. Laura J. Moore and colleagues from the Methodist Hospital, Weill Cornell Medical College in Houston.
The study authors found that patient risk factors for sepsis and septic shock include being older than 60, undergoing emergency surgery, and having co-existing illnesses. Having a co-existing health problem increased the risk of sepsis and septic shock sixfold and the risk of dying within 30 days 22-fold.
"By identifying three major risk factors for the development of and death from sepsis and septic shock in general-surgery patients, we can heighten our awareness" of those threats to this at-risk population, the researchers noted.
"The implementation of mandatory sepsis screening for these high-risk populations has resulted in decreased sepsis-related mortality within our institution," Moore and her colleagues wrote. Further evaluation of the role of sepsis screening programs in other settings is "critical" and could significantly reduce related mortality in general-surgery patients, they concluded.
The Society of Critical Care Medicine has more about sepsis (http://ssc.sccm.org/sepsis/what_you_should_know ).
SOURCE: JAMA/Archives journals, news release, July 19, 2010