Editorial

A Campaign Worth Joining: Improving Outcome in Severe Sepsis and Septic Shock Using the Surviving Sepsis Campaign Guidelines

Authors: Gourang P. Patel, PharmD, BCPS, Ellen H. Elpern, RN, APN, Robert A. Balk, MD

Abstract

When the systemic response to infection leads to organ dysfunction, it is termed severe sepsis.1 Severe sepsis and septic shock are the 10th leading cause of death in the United States and one of the two most common causes of death in the noncoronary intensive care unit.2 Currently sepsis mortality rates range from 12 up to 85%. The highest mortality rates are present when there is septic shock and multiple organ dysfunction syndrome.2 A recent review of 22 years of National Hospital Discharge Survey codes demonstrated an increase in the incidence of sepsis among both men and women, as well as all races.3 This study also demonstrated that Gram positive organisms are more commonly found than Gram negative organisms and there has been a dramatic increase in fungal organisms as the cause of sepsis. Other studies have reported that the most common site of infection is the pulmonary system with the abdomen being the second most common site.4 Angus et al5 have also suggested, based on extrapolation of discharge coding data from 7 states, that the annual number of severe septic patients in the United States is 750,000. The forecast for the future is quite depressing since it is expected that the yearly incidence will continue to rise at 1.5% per year, based on the growing number of elderly individuals, increased use of invasive and diagnostic procedures, increased use of immunosuppressive and cytotoxic therapies, growing number of individuals who are immunosuppressed, the increase in antibiotic resistance among common bacteria, and possibly our increased awareness of severe sepsis and its sequelae.2,5

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