“Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever ...” — Sir William Osler
Thursday was designated as World Sepsis Day. You probably know little or nothing about sepsis, but it is more common and more deadly than diseases you hear about regularly.
Sepsis, the body’s response to severe infections, kills more people than breast cancer, prostate cancer and HIV/AIDS combined. It is the most common cause of hospital deaths in the United States, ahead of both myocardial infarction (heart attacks) and stroke.
When people speak of death due to infection, they are generally referring to severe sepsis and septic shock, both of which have high mortality rates. Between 2000 and 2007, the incidence of sepsis in the United States increased 10 percent each year. Despite advances in sepsis management that have improved the chances of surviving this disease, the increasing number of people developing sepsis has caused more people to die than ever before.
In 2005, Santa Barbara Cottage Hospital began a comprehensive program of better treating sepsis patients, and put in place the Slay Sepsis Protocol. We were one of the first hospitals in California, and indeed nationally, to implement such a protocol. This initiative was highly successful, cutting the death rate from septic shock and severe sepsis by 50 percent. These two types of sepsis are the most deadly forms of the disease.
We were not satisfied with this success, however, and continued to monitor and refine our process. This year, we have cut the mortality by another 33 percent. We currently have one of the best survival rates of sepsis in California, and most likely in the entire country. Our survival rates are better than almost any reported in the medical literature.
There are hundreds of our patients in Santa Barbara who are alive today solely because of this protocol. This success has not come easily. It has been the direct result of the hard work of the hospital staff, medical staff and the resident house staff, all of whom are extremely dedicated to improving the outcomes for our sepsis patients.
We do more than treat people who arrive at the hospital with infections — we actively prevent infections in patients who are hospitalized with other problems. We routinely and closely track hospital-acquired infections and have put in place multiple programs over the past five years to reduce or eliminate them. We have also been extremely successful in this effort. For example, in our Medical Intensive Care Unit (ICU) and our Neonatal ICU, we have not had a single documented ventilator-associated case of pneumonia in almost four years. Our mortality rates of this disease in our Surgical ICU and Pediatric ICU are well below the national average.
Vascular catheters are another frequent source of hospital-acquired infection. Our efforts have cut these rates to less than half the national average, and in some areas we have eliminated them completely. Our surgical site infections are 75 percent below the national average. In fact, we are at, or more often well below, the national benchmarks for almost every type of hospital-acquired infection. Our sister hospitals — Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital — have implemented similar programs and protocols, and similarly have rates of zero or near zero for these infections.
Simply put, our rates for treating and preventing severe infections at Cottage Health System hospitals are among the best of any in California. As a resident of the greater Santa Barbara area, you should be confident that if you have a severe infection requiring hospitalization, you will get the best treatment available — in the timeliest manner possible. If you are hospitalized for other reasons, your chance of acquiring an infection is nearly nonexistent. That’s definitely something to celebrate, on World Sepsis Day!
For more information, please click here to visit the Cottage website and check Sepsis and Infection Control in the Quality Report section.
— Jeffrey Fried, MD, FCCM, FCCP, is the chief medical director of adult critical care for Santa Barbara Cottage Hospital.
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