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Prompt Sepsis Care Increases Survival in Children

August 29th, 2018

Sepsis, a complication caused by the body's overwhelming and life-threatening response to infection, is the leading cause of death in hospitalized patients. More than 1.5 million people get sepsis each year in the United States, and about 250,000 die from the condition. Children with sepsis tend to worsen particularly quickly – looking relatively healthy one moment and needing life support within hours. Unfortunately, more than one in 10 children hospitalized with sepsis do not survive, but a new analysis led by the University of Pittsburgh reports that a series of tests and treatments known as “Rory’s Regulations” can increase the chances of survival.

Symptoms of sepsis can include breathing problems, fast heartbeat, fever, chills, cool clammy skin, skin rashes, confusion, and shaking, but the condition is often misdiagnosed. After undiagnosed sepsis following an infection from a minor scrape caused the death of a 12-year-old boy named Rory in 2012, New York became the first state to require that hospitals follow guidelines to quickly identify and treat the condition. Under Rory’s Regulations, hospitals must perform blood tests, administer IV fluids, and begin antibiotics within one hour of a sepsis diagnosis.

In an effort to find out if the new regulations are saving lives, University of Pittsburgh researcher Christopher W. Seymour, MD, MSc, and his team analyzed the outcomes of 1,179 children with sepsis reported at 54 New York hospitals between April 1, 2014, and Dec. 31, 2016. Results published in the Journal of the American Medical Association showed that completing the sepsis protocol within one hour decreased the odds of death by 40 percent. Importantly, these findings only held true when the entire three-part bundle of testing and treating was completed.

While the implementation of the regulations was initially controversial, these findings will likely encourage the mandate’s expansion into other states. “No child should die from a treatable infection,” said Dr. Seymour. “This is the best evidence to date that prompt identification and treatment of suspected sepsis leads to better outcomes in children.”

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