Sepsis Symptoms, Causes and Treatment

Every year, more than 1.7 million Americans develop sepsis, a life-threatening medical condition that arises when the body initiates a powerful immune response against an infection. Anyone can get sepsis. But two-thirds of all sepsis cases occur in people over 60. Sepsis kills more people in the United States than breast cancer, prostate cancer, and AIDS combined. Older adults, especially those with chronic health conditions, like heart disease and various types of cancer, are more likely to succumb to sepsis. However, early recognition of sepsis symptoms can save lives and reduce the risk of long-term effects.

Sepsis is caused by bacterial, viral, parasitic, or fungal microbial infections that trigger overwhelming inflammation and blood thickening. Normally, the body’s immune system targets invading microbes with a tempered response. However, in sepsis the body overreacts, triggering a cascade of chemical messengers that cause inflammation within blood vessel linings. When this happens, small blood clots form–first at the site of infection and then throughout the body. Widespread inflammation and blood clotting impede oxygen and nutrient delivery to tissues and organs, resulting in organ dysfunction. An infection may begin in an organ like the lungs or kidney or be introduced through an open sore, surgical incision, or invasive medical devices like a urinary catheter or feeding tube.

Common symptoms of sepsis include fever, rapid heart rate, and rapid breathing. The organ affected by the infection often dictates the other signs and symptoms of sepsis. For example, if the lung is the primary site of infection, as in pneumonia, the person may experience fever, coupled with shortness of breath, painful coughing, and discoloured mucous. Not all infections develop into sepsis, however, the progression from a localized infection to full-blown sepsis can occur within hours. Therefore, it is important to swiftly recognize the signs and symptoms of an infection that’s out of control. When an older person becomes septic fever may be absent. In fact, the opposite can occur with the development of a cold, clammy skin temperature–known as hypothermia.

Older patients are also more likely to exhibit sudden mental confusion or delirium as a major part of their presenting signs, along with fatigue, malaise, weakness, sudden shortness of breath, poor appetite, chills, dizziness, and low blood pressure. When these symptoms occur, coupled with an infection, it is time to seek immediate medical attention. Older adults may be resistant to urgent medical care, but timely medical treatment is imperative to increase survival, since for every hour delay inappropriate treatment, the risk of death increases by up to 8 per cent. Sepsis becomes more dangerous with age, and treatment is more likely to involve hospitalization and admission to the intensive care unit or ICU. 70 per cent of sepsis hospitalizations are in adults 60 years and older. Older adults admitted to the ICU for sepsis are also generally sicker, require longer lengths of stay, and may experience significant long-term cognitive impairment and physical limitations. Among older adults who do survive sepsis, 76 per cent are more likely to be discharged to a skilled nursing facility, unable to return home. To limit sepsis-causing infections–seniors, their loved ones, and caregivers should receive flu and pneumonia vaccinations, and practice good hand-washing and good personal hygiene. Wound dressing and nursing care should use sterile techniques whenever feasible. Sepsis is common, deadly, and costly. It affects older Americans in disproportionate numbers. Weakened immunity, recent surgery, skin ulcerations, and chronic diseases such as diabetes, cancer, autoimmune disorders, or malnutrition make seniors more vulnerable to sepsis. To help reduce sepsis deaths in seniors, practice preventative strategies that reduce the spread of germs, know the signs of sepsis, and seek early treatment. Together, we can save lives.