A resolution recently adopted by the World Health Organization’s (WHO) World Health Assembly (WHA) could slash the incidence and impact of sepsis, experts believe. In a recent issue of the New England Journal of Medicine, an international group of sepsis and global health researchers urged stakeholders from decision-makers to clinicians to implement the new resolution’s recommendations.
“The WHA [the WHO’s decision-making body] resolution, with its implicit recognition of sepsis as a major threat to patient safety and global health, has the potential to save millions of lives,” emphasized Konrad Reinhart, MD, a researcher at Jena University Hospital in Germany, and his co-investigators. If the resolution, which includes more than 30 recommendations and suggested actions, is implemented in member countries, one important gain could be a better understanding of the prevalence and impact of sepsis, Dr Reinhart and colleagues said.
Currently, the incidence of sepsis is estimated at 30 million individuals per year — with 6 million resulting in death — but those statistics largely leave out the 87% of the world’s population that live in low- and middle-income countries (LMICs), Dr Reinhart and colleagues said.
“This lack of data is compounded by the fact that sepsis is treated as a ‘garbage code’ in the Global Burden of Disease statistics, where most deaths due to sepsis are classified as being caused by the underlying infection,” they wrote.
Along with improved coding schemes to help obtain a more accurate picture of the epidemiology and impact of sepsis, the WHA resolution calls on member countries to increase awareness of sepsis among healthcare workers — who need to be mindful of the time-critical nature of sepsis treatment — and among the public, given that an estimated 70% of sepsis cases are community-acquired.
“[Since] treatment with appropriate antibiotics must begin early to be effective, educating people about seeking treatment without delay is key to preventing unnecessary deaths and disability,” said Dr Reinhart, pointing to public awareness campaigns in the United States that have increased the number of people who have heard of sepsis to 55%.
In the United States, New York State’s “Rory’s Regulations” led to a legislation mandating better treatment guidelines for pediatric sepsis patient that increased patient communication and enhanced the role of parents when their children are in the hospital, the investigators noted.
For example, they write, “attention to bolstering public health initiatives to prevent sepsis, improving surveillance systems for detecting outbreaks early, and provision of simple early treatment can help to counterbalance the effects of a lack of critical care facilities in many LMICs.”
“Actions will vary by region and country and must acknowledge the unique challenges faced by LMICs,” they concluded.
Selected World Health Assembly Recommendations to Reduce the Global Burden on Sepsis:
- Develop national policies and processes to improve the prevention, diagnosis, and treatment of sepsis
- Improve strategies for infection prevention and control
- Continue to combat antimicrobial resistance
- Develop and implement measures to recognize and manage sepsis
- Increase public awareness of sepsis
- Train healthcare workers about the time-critical nature of treating sepsis
- Promote research to develop innovative ways of preventing, diagnosing, and treating sepsis
- Improve coding to allow for a better assessment of the burden of sepsis and antimicrobial resistance locally and globally
Reinhart K, Daniels R, Kissoon N, Machado FR, Schachter RD, and Finfer S. Recognizing Sepsis as a Global Health Priority – a WHO Resolution. NEJM. 2017;377:414-417.