[현대건강신문=박현진 기자] To save a sepsis patient with a high mortality rate, antibiotic treatment should be done quickly during the sepsis treatment bundle, but it was found that antibiotics could not be prescribed quickly due to the inadequacy of the system for sepsis in the emergency room.
Sepsis is a life-threatening disease that destroys vital organs such as the lungs because the immune response is not properly regulated after bacteria enter the body.
“Every year, about 50 million people around the world suffer from this disease, and about 11 million of them die,” said Seo Ji-young, president of the Korean Society of Critical Care Medicine (referred to from hereafter as the Society of Critical Care Medicine) “Even if they do not die from the disease, many survivors complain of a variety of physical and psychological pain,” he said.
As a result of a survey by the Society of Critical Care Medicine, the mortality rates of community-occurring sepsis and nosocomial sepsis were 26.0% and 34.4%, respectively, and the mortality rate was higher in nosocomial sepsis. As of 2021, the death rate from sepsis in Korea is on a downward trend to 27.7%, but it is still higher than that of other countries.
At a symposium held on the 13th commemoration of ‘World Sepsis Day’, Professor Su-yeon Lee of the Department of Intensive Care Medicine, Asan Medical Center, Seoul, said, “In Korea, community-acquired sepsis was 644 of cases per 100,000 emergency room visits, and hospital-acquired sepsis was 94 cases per 100,000 hospitalized patients “It should be possible to select, diagnose, and treat hospital-acquired sepsis through a rapid response system,” he said.
Many of the patients who visit the emergency room are diagnosed with sepsis, but the diagnosis and treatment are delayed, resulting in death.
The Korean Society for Sepsis, which includes the Society of Critical Care Medicine, the Korean Society of Emergency Medicine, and the Korean Society of Infectious Diseases, asked 24 items from 163 experts nationwide to treat sepsis.
In particular, sepsis has a high mortality rate, and only 4 out of 10 experts answered that such treatment is carried out despite the need for bundled treatment within a short time.
Bundled treatment refers to treating a sepsis patient with △ measurement of lactate concentration △ blood culture test △ administration of antibiotics and fluids △ immediate administration of vasopressors.
At the symposium, Professor Lim Seong-yoon of the Department of Intensive Care Medicine of Seoul National University Hospital, Bundang, said, “Foreign critical care associations recommend that five bundle procedures be performed within an hour.” he said.
As a result of this survey, the sepsis bundle treatment performance rate was △ 5.6% for community-onset sepsis performed within 1 hour, 11.4% for hospital-acquired sepsis and △ 33.6% for sepsis community-acquired and 27.7% for hospital-acquired sepsis performed within 3 hours. .
Professor Im Seong-yoon pointed out that the most important antibiotic treatment for treating sepsis is not performed properly.
When asked how many hours it takes to administer antibiotics to sepsis patients, only 41.7% of respondents answered within 1 hour, 52.1% within 3 hours, and 5.5% within 5 hours.
Professor Lim said, “It has been shown that antibiotics important for sepsis treatment are not available in the emergency room, and it takes time to get them from the hospital pharmacy.
67% of respondents said that the ‘blood culture test’ required for diagnosis was also delayed due to lack of manpower.
As a result of this investigation, factors impeding bundle treatment include △ Absence of an automatic scoring system for monitoring and diagnosing sepsis △ Absence of on-site diagnostic testing equipment to measure miscarriage △ No antibiotics available on the site for performing bundle treatment △ Lack of staff for sepsis treatment △ Diagnosis of sepsis It was found that there was a lack of awareness of sepsis bundle treatment criteria and treatment.
Professor Lim emphasized, “Several papers have shown that sepsis mortality is significantly reduced when five bundles are administered.
