HCA Healthcare: Algorithm helping detect Sepsis early

The body’s toxic response to an infection is among the top 5 leading causes of death.

  • By Dan Macdonald
  • | 12:00 a.m. September 21, 2022
  • | 5 Free Articles Remaining!
Chief Medical Officer Albert Holt IV
Chief Medical Officer Albert Holt IV
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Sepsis is a killer. It has been reported by the World Health Organization as the primary cause of death in United States hospitals.

It kills more than 270,000 annually, which is more than breast cancer, prostate cancer and AIDS combined, according to the Sepsis Alliance. 

The group is a national charitable organization working to reduce sepsis suffering and improve awareness and care, according to its website.

 Sepsis is defined by sepsis.org as the body’s overactive and toxic response to an infection. The development of sepsis can lead to tissue damage and it can spread, causing organ failure and death.

Sepsis can result when the body is weakened by other conditions.

Because early detection is the primary way to combat sepsis, HCA Florida Memorial Hospital is developing a treatment protocol. 

HCA Healthcare comprises 185 affiliated hospitals throughout the United States and the United Kingdom. 

Affiliated facilities provide about 5% of the major U.S .hospital procedures, according to a 2020 report in The New England Journal of Medicine.

HCA Healthcare physicians are employing an algorithm called Sepsis Prediction and Optimization of Therapy, which is showing positive results, according to the publication.

Eight months after employing it, there were 1,200 fewer sepsis deaths systemwide than the comparable eight months the year before.

In Northeast Florida, Chief Medical Officer Albert Holt IV is seeing better outcomes since the treatment has become a regular part of patient care. A patient being treated for an infection is immediately monitored for the four causes of sepsis.

“Our expectation is that if a nurse gets a SPOT alert that they will respond within 10 minutes or less,” Holt said.

The nurse notifies a doctor or advanced practitioner for care instructions.

“If they are concerned that the patient could be becoming septic they’ll draw cultures and start antibiotics.”

The algorithm is built into the electronic medical record scanning for potential sepsis patients using criteria that sepsis may be present. 

The criteria are the body temperature is higher than 100.4 degrees or lower than 96.8 degrees; the heart rate is more than 90 beats per minute; the respiratory rate is higher than 20 breaths per minute; and the white blood count is greater than 12,000 cells per millimeter or less than 4,000 cells per millimeter.

If two or more are present and there is suspicion or evidence of infection as well, then sepsis is likely.  

If a patient is in septic shock, for every hour treatment is delayed, there is an 8% increase in the chance of mortality, Holt said.

“Each year about 1.7 million or so get it and about 270,000 die from sepsis. That’s about a 15% mortality rate. And that is all from sepsis,” he said.

He said that as long as new viral strains mutate, there will be infections and early detection remains the best tool to lessen the affects of sepsis.

“If we think sepsis is present we are going to start treating rather than waiting for something ironclad,” Holt said.

“The delay of antibiotics is the biggest killer.”



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