There have been many attempts to redefine sepsis and septic shock to create the most consistent diagnoses, which would help physicians to diagnose early and code for the disease appropriately. It is difficult to define and diagnose, as the symptoms that can trigger a diagnostic test are similar to many other infections. The challenging nature of the condition highlights the need for a consistent definition accepted by all physicians. In its simplest form of the CDC’s definition, “sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency.”
Sepsis has placed an immense toll on the people it affects and the healthcare system as a whole. Sepsis was the cause of hundreds of millions of hospitalizations in the United States between 1979 through 2000, with an estimated cost of $17 billion annually during that time, and “killing 20 to 50 percent of severely affected patients.” According to the CDC, in a typical year, 1.7 million adults in America develop sepsis, with nearly 270,000 dying of the disease. Sepsis makes up one in three patient deaths in a hospital.3 Sepsis makes up one in three patient deaths in a hospital.
Sepsis makes up one in three patient deaths in a hospital.
Despite the prevalence of sepsis in America, fewer than half of Americans have heard of this disease, according to the CDC. The need for more awareness is why, in 2011, the Sepsis Alliance designated September as Sepsis Awareness Month. The month is not to just bring attention to the adults suffering from this disease, but also the children who develop it. After a change in the definition in 2016, a separate task force was set up to establish guidelines for sepsis in pediatric patients. This was the plan set forth by the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM), because as SCCM notes:
“Population-based studies of the prevalence of pediatric sepsis estimate 72-89 cases per 100,000 pediatric population in the United States, with over 50,000-75,000 hospitalizations for pediatric sepsis and an associated cost near $5 billion annually… Over 4% of all hospitalized patients younger than 18 years and 8% of pediatric intensive care unit (PICU) patients in the United States have sepsis.”
The goal of the guidelines set up by the SCCM was to allow for earlier detection of sepsis in children, many of whom are very vulnerable as their immune systems have not fully developed. The SCCM released a new set of guidelines and best practices for diagnosing and treating sepsis in children in February 2020.
The guidelines provided by the SCCM focused on creating better outcomes for children through early detection and protocols to focus treatment and recognition. Pediatricians must understand these guidelines and the diagnostic tools necessary to diagnose the problem earlier, as there can be an improvement in mortality overall.
Consistent protocols also have the added benefit, when pediatricians are familiar with coding and clinical documentation improvement (CDI) with sepsis, of diagnosing sepsis at an earlier stage in its development and creating a better patient outcome through this knowledge. Then, with the added help of an experienced coding and clinical documentation integrity partner, like Accuity, the coding plan for sepsis can be standardized within an organization.
This standardization will help keep healthcare professionals aligned with the diagnosis, treatment, and coding of sepsis to focus on healing the vulnerable children in the world.