By Cesar M Limjoco, M.D.
Chief Medical Officer
This is a highly simplified and dramatized scenario that nevertheless requires serious consideration. In a hypothetical hospital, 3 decades of sepsis morbidity and mortality data showed a marked decrease in sepsis mortality from 100% to 25% to 10% in three successive decades. Is this representative of health care delivery at its best?
Let’s dig deeper. In the first decade, their physicians only called a case “sepsis” when the blood cultures were positive and was in multi-organ failure. In the second decade, there was a realization that only 30% of patients who are septic had positive blood cultures but already had end organ dysfunction or outright failure. The third decade saw a change in perspective wherein every patient with an infection that satisfied criteria were called “septic.” In effect, all patients admitted with an infection were diagnosed as having “Sepsis.”
Is this good Medicine? The second decade arguably could come to that conclusion because interventions were accorded earlier to a wider patient population. But, what about the third decade? Was placing all patients on sepsis protocol really making a difference in sepsis mortality? Or, were they unnecessarily placing patients with no true indication for the big guns of sepsis protocol to higher risk of morbidity and mortality?
Food for thought…? (Note: also view insightful comments on the original LinkedIn post, https://www.linkedin.com/posts/cesarmlimjocomd_this-is-a-highly-simplified-and-dramatized-activity-6580136030433796097-WApO)