Sepsis—a condition that arises when the body’s response to an infection causes injury to its own tissues and organs—is the number-one cause of death in hospital patients. At least 1.5 million sepsis cases occur in the United States annually.
After undiagnosed sepsis caused the death of a 12-year-old boy, Rory, in 2012, New York became the first state to require that hospitals follow a protocol to quickly identify and treat the condition. “Rory’s Regulations” require hospitals to follow protocols for early identification and treatment of sepsis and submit data on compliance and outcomes. Hospitals can tailor how they implement the protocols but must include a blood culture to test for infection, measurement of blood lactate (a sign of tissue stress), and administration of antibiotics within three hours of diagnosis. This is known as the “three-hour bundle.”
While there was controversy in the medical community about whether the protocol actually saved lives, a new University of Pittsburgh School of Medicine study covering nearly 50,000 patients from 149 New York hospitals is the first to offer scientific evidence that “Rory’s Regulations” work. “Some question the benefit of rapid treatment with protocols, saying they can have unintended side effects and be a distraction in busy emergency departments,” said lead author of the study, Christopher W. Seymour, MD, MSc. “After reviewing the data, we can finally say that faster is better when it comes to sepsis care.”