The Economic and Humanistic Burden of Severe Sepsis

Abstract

Sepsis and severe sepsis in particular remain a major health problem worldwide. Their cost to society extends well beyond lives lost, as the impact of survivorship is increasingly felt. A review of the medical literature was completed in MEDLINE using the search phrases "severe sepsis" and "septic shock" and the MeSH terms "epidemiology", "statistics", "mortality", "economics", and "quality of life". Results were limited to human trials that were published in English from 2002 to 2014. Articles were classified by dominant themes to address epidemiology and outcomes, including quality of life of both patient and family caregivers, as well as societal costs. The severity of sepsis is determined by the number of organ failures and the presence of shock. In most developed countries, severe sepsis and septic shock account for disproportionate mortality and resource utilization. Although mortality rates have decreased, overall mortality continues to increase and is projected to accelerate as people live longer with more chronic illness. Among those who do survive, impaired quality of life, increased dependence, and rehospitalization increase healthcare consumption and, along with increased mortality, all contribute to the humanistic burden of severe sepsis. A large part of the economic burden of severe sepsis occurs after discharge. Initial inpatient costs represent only 30 % of the total cost and are related to severity and length of stay, whereas lost productivity and other indirect medical costs following hospitalization account for the majority of the economic burden of sepsis. Timeliness of treatment as well as avoidance of intensive care unit (ICU)-acquired illness/morbidity lead to important differences in both cost and outcome of treatment for severe sepsis and represent areas where improvement in care is possible. The degree of sophistication of a health system from a national perspective results in significant differences in resource use and outcomes for patients with serious infections. Comprehensive understanding of the cost and humanistic burden of severe sepsis provides an initial practical framework for health policy development and resource use.

Delivering Prolonged Intensive Care to a Non-human Primate: A High Fidelity Animal Model of Critical Illness

“…While there has been a trend toward the reduction of acute care beds since 2000, the opposite has been observed in the number of critical care beds 1 . Further pressure on critical care capacity is expected as the population ages and survival for chronic conditions is prolonged 1, 2 . The leading cause for admission to an intensive care unit (ICU) is infection and sepsis, accounting for approximately 10 to 45% of ICU stays depending on a variety of health system factors 2, 3 .…”

“…Further pressure on critical care capacity is expected as the population ages and survival for chronic conditions is prolonged 1, 2 . The leading cause for admission to an intensive care unit (ICU) is infection and sepsis, accounting for approximately 10 to 45% of ICU stays depending on a variety of health system factors 2, 3 . Despite advances in critical care science, septic shock, as recently defined by the Sepsis-3 task force, carries a mortality rate of 35–54% 4 , with sepsis syndromes resulting in 250,000 deaths annually in the United States alone 5 .…”

NETIMIS: Dynamic Simulation of Health Economics Outcomes Using Big Data

“…This example was motivated by the need for a model to assess interventions using Point-of-care Testing (POCT) devices [41] that have the potential to improve the early detection of severe sepsis [42,43]. Model development was based on pair working.…”

Rapid Adsorption of Proinflammatory Cytokines by Graphene Nanoplatelets and Their Composites for Extracorporeal Detoxification

“…Between 1993 and 2003, the number of hospitalizations for severe sepsis doubled in the United States [1]. Sepsis is the primary cause of death for children and infants [2,3], and the number of incidences was estimated at over 19 million cases worldwide annually [4]. Sepsis conditions progress as a function of the cytokine cascade, an exaggerated immune response to the incident infection [5].…”