Tip: Sepsis innovations for earlier detection, decreased mortality rates

The Sepsis Alliance estimates that sepsis accounts for nearly $24 billion in annual healthcare costs and claims 258,000 patients’ lives each year nationwide, HealthLeaders Media reported. Because of these costs, hospitals are constantly trying to develop different approaches to reduce sepsis morbidity and mortality.

Recently, HealthLeaders Media spoke with Nemours Children’s Hospital in Orlando about their best tactic related to sepsis care: remote monitoring.

In 2015, Nemours began their multifaceted approach to sepsis care that dropped related mortality rates from 12.5% in 2016 to zero during the first six months of 2018. While there were many factors that contributed to the decrease, remote monitoring was one of the primary drivers, one of the physicians involved in the project, Jennifer Setlik, MD, told HealthLeaders Media.

Essentially, the Nemours Clinical Logistics Center provides 24/7 remote monitoring by paramedics who observe all patients in the ED and in every hospital bed (excluding the NICU, as it has separate protocols. The patients’ vitals and other data are aggregated into a shock/sepsis score using a home-grown scoring system that gives a greater weight to blood pressure changes.

If the patient’s score reaches a threshold value of 25 or more points, paramedics receive a visual cue and prompt a bedside nurse to gather additional information. If, after further assessments, the patient has a score of 45 points of higher, a rapid response team is deployed as the child is at an elevated risk of shock and sepsis.

While this approach has been successful for Nemours, there are many other approaches to sepsis in development, according to HealthLeaders Media.

For example, innovators at Emory University are testing their Artificial Intelligence Sepsis Expert using real-time data. It can already accurately predict the onset of sepsis in an ICU patient four to 12 hours prior to clinical recognition, HealthLeaders Media reported, and it has an accuracy rate of 85-90%.

It may be up to five years before the device is commercially available, but initial forms of the Sepsis Expert may be available for testing in academic health environments as soon as next year, HealthLeaders Media reported.

Other organizations, such as Immunexpress based in Seattle, have taken a different approach the sepsis battle. Currently, clinicians rely on detecting pathogens in blood cultures to diagnose sepsis, but this process takes time and doesn’t necessarily offer a conclusive diagnosis, according to HealthLeaders Media.

Since each hour without treatment increases mortality, Immunexpress developed a test (called SeptiCyte) to measure the body’s specific immune response to infection by examining biomarkers in the patient’s blood, which is much faster than the traditional blood cultures.

According to Rolland Carlson, PhD, CEO of Immunexpress, those biomarkers may hold the key to the early and accurate detection of infection, as well as assist in guiding the use and timing of drugs and other therapies.

SeptiCyte has received FDA approval and conducted some initial clinical trials at Seattle Children’s Hospital. The company is continuing tests on a different platform and expects to have the product commercially available in 2019, HealthLeaders Media reported.

Editor’s note: This article originally appeared in HealthLeaders Media. To read about compliance rates with CMS’ sepsis bundle, click here. To read a recent article on sepsis criteria, click here. To read about the recent update to the Surviving Sepsis Campaign guidelines, click here.