How Long Does it Take to Die From Sepsis?

Sepsis is a life-threatening condition that occurs when the body’s response to an infection triggers widespread inflammation throughout the body. This can cause tissue damage, organ failure, and death. For nursing home residents, sepsis risks are higher due to their age, pre-existing conditions, and substandard care. 

What is Sepsis?

Sepsis is a severe and often deadly syndrome that triggers the body’s response to an infection. Any person with an illness may potentially develop sepsis, especially those with specific conditions such as age and chronic diseases. 

Sepsis usually results from lung, skin, urinary tract, or gastrointestinal infections. Blood poisoning, which is associated with infections that can cause sepsis, highlights the importance of early detection, especially for the geriatric population and those with chronic illness. 

When the body overreacts to an infection, it releases chemicals into the bloodstream that cause inflammation all over the body. This inflammation can cause blood clots and leaky blood vessels, which impairs blood flow and prevents nutrients and oxygen from reaching vital organs.

With no immediate treatment, sepsis can progress rapidly to severe tissue damage, organ failure, and death. Sepsis is often associated with bacterial infections, but viral infections like COVID-19 and the flu can also trigger it. 

According to the Centers for Disease Control and Prevention (CDC), sepsis-related infection affects over 1.5 million people in the US each year and is responsible for over 270,000 deaths a year.

The Stages of Sepsis

Sepsis is a complex condition that goes through three stages: sepsis, severe sepsis, and septic shock. Understanding each stage is critical to early detection and treatment.

Stage 1: Sepsis

The first stage of sepsis is often challenging to detect as the symptoms are subtle and can be mistaken for other conditions. Common signs of sepsis in this stage are:

• High fever (above 101°F or 38°C) or low temperature (below 96.8°F or 36°C)
• Rapid heart rate (above 90 beats per minute)
• Increased respiratory rate (over 20 breaths per minute)
• Confirmed infection through positive, bacterial, fungal, or viral blood culture results

A medical professional or healthcare provider must identify at least two of these early symptoms to diagnose sepsis. Early intervention at this stage can often be treated with antibiotics. Most patients diagnosed in the early stages of sepsis will fully recover if treated promptly.

Stage 2: Severe Sepsis

If sepsis is not detected and treated in the early stage, it can progress to severe sepsis, which can cause life-threatening organ dysfunction. Symptoms of severe sepsis infection are:

• Abnormal heart function, irregular heartbeat, or poor cardiac output
• Decreased urine output kidney dysfunction
• Sudden change in mental state, confusion, or disorientation
• Difficulty breathing or acute respiratory distress syndrome (ARDS)
• Severe pain or discomfort in various parts of the body
• Chills and extreme weakness due to low body temperature
• Unconsciousness or significant confusion

Severe sepsis means the infection is affecting the body’s organs. This stage requires immediate medical attention to prevent progression to septic shock. The SSC Sepsis 6 bundle is a set of medical guidelines healthcare providers use to manage severe sepsis, including monitoring urine output and treatment.

Stage 3: Septic Shock and Drop in Blood Pressure

Septic shock is the most severe and critical stage of sepsis. Despite medical treatment, patients in this stage have critically low blood pressure that does not respond to fluid resuscitation. When treating sepsis, the symptoms of septic shock are:

• Drop in blood pressure that does not respond to fluids
• Elevated serum lactate, poor tissue oxygenation
• Organ dysfunction involving multiple systems: heart, lungs, kidneys, and liver

Patients in septic shock have an increased risk of death; the mortality rate is 30-50%. This sepsis diagnosis is a medical emergency and requires aggressive treatment to improve survival. Elevated lactate levels, a byproduct of anaerobic metabolism, are a critical marker for septic shock and are closely monitored by healthcare providers.

Post Sepsis Syndrome

Surviving sepsis does not always mean complete recovery. Many sepsis patients, especially those who have been in the intensive care unit (ICU), are more prone to post-sepsis syndrome (PSS). 

PSS is a collection of physical and psychological symptoms that can occur long after treating the initial infection. Common symptoms of PSS are:

• Sleep disturbances and fatigue
• Joint pain and muscle weakness
• Breathing difficulty and shortness of breath
• Cognitive impairment, memory loss, and difficulty concentrating
• Psychological issues, depression, anxiety, and post-traumatic stress disorder (PTSD)

PSS can affect a survivor’s quality of life and lead to rehospitalization and long-term health problems. The National Institutes of Health (NIH) states that survivors of sepsis are at risk for cognitive and functional disability and emotional and psychological challenges.

How Sepsis Progresses

Sepsis is a rapidly progressing bacterial infection that can progress from mild symptoms to life-threatening complications in hours. The speed of progression depends on many factors, including type and source of infection, patient’s overall health, and timely treatment.

Clinical studies have shown that sepsis progresses faster in patients with certain infections, such as bacteremia, peritonitis, and pneumonia. Blood cultures are used to identify bacteria or other pathogens that may be causing the infection. Patients diagnosed with septic shock from the onset have the highest risk of death, especially within the first 28 days of diagnosis.

Early treatment or medical intervention is critical to prevent sepsis from progressing. For every hour that treatment is delayed, the risk of death increases by 8%.

How Long Does It Take To Die From Sepsis?

Many sepsis infections can kill in as little as 12 hours if untreated. Research shows that sepsis is the third leading cause of death, even more than breast cancer, lung cancer, and heart attack. The rapid onset and progression of sepsis is a medical emergency that needs immediate attention.

The mortality rate of sepsis depends on the stage. Patients with mild sepsis can recover fully with prompt treatment, while those with severe sepsis or septic shock are at higher risk of death. Studies show that the mortality rate for septic shock can be as high as 40%. Many survivors will have ongoing health challenges and an increased risk of future infections.

Risk Factors for Sepsis

Anyone can get sepsis, but specific populations are at higher risk due to underlying health conditions, age, and other factors. The following are more prone to sepsis:

• Elderly adults, especially those over 65, may have weakened immune systems and multiple chronic health conditions.
• Patients with chronic diseases such as cancer, diabetes, respiratory diseases, kidney disease, AIDS, and liver disease are at higher risk of developing sepsis. Chronic illnesses can worsen the severity of infections that can lead to sepsis.
• Individuals with weakened immune systems, those undergoing chemotherapy, organ transplant recipients, and patients with metabolic acidosis.
• Recent surgical patients or those hospitalized, especially in intensive care units (ICUs)
• Infants and young children, especially those with low birth weight or born premature, may have immature immune systems.

Other risk factors are invasive medical devices such as breathing tubes, intravenous (IV) lines, and catheters, which can introduce pathogens into the body. Patients who have survived sepsis are also at higher risk in the future.

Newborns and Sepsis

Neonatal sepsis is a big concern for newborns, especially those born premature or with low birth weight. Sepsis in newborns can occur within the first month of life and is classified as early onset or late onset, depending on when the infection is acquired. Early-onset sepsis is acquired during birth, while late-onset sepsis occurs after birth.

The signs of sepsis in newborns are subtle and non-specific, making early diagnosis difficult. Common symptoms are:

• Abdominal pain and swelling
• Difficulty feeding or poor feeding habits
• Low body temperature or fever
• Respiratory distress, including apnea (temporary stop of breathing)
• Jaundice or yellowing of the skin
• Seizures or jitteriness

Early treatment is crucial for newborns with sepsis, as delayed treatment can be life-threatening. Maternal screening, neonatal screening, and proper medical care can reduce the risk of sepsis in newborns.

Seniors and Sepsis: Weakened Immune System

Older adults are more prone to sepsis due to:

• It weakens the immune system, which slows down the body’s ability to fight infections and heal wounds.
• Chronic conditions such as arthritis, diabetes, and malnutrition increase the risk of infection.
• Frequent infections, such as a urinary tract infection (UTI) and respiratory infections like pneumonia, are common in older adults.

The early signs of sepsis in seniors are hard to recognize and can lead to delays in treatment. This delay can lead to faster progression of the condition and a higher risk of death. 

According to Sepsis Alliance, people 65 and above are 13 times more likely to be hospitalized for sepsis than younger individuals. Seniors who recover from sepsis are also at higher risk of repeated infections, organ damage, PTSD, chronic pain, and fatigue.

Serious Consequences of Sepsis

As sepsis progresses, it can cause significant damage to the body’s organs and tissues. Some of the severe consequences of sepsis are:

• Permanent brain damage due to lack of oxygen or blood flow
• Kidney failure may require long-term dialysis or chronic kidney disease
• Lung damage is often due to mechanical ventilation during treatment
• Heart valve damage can impair the heart’s function

Sepsis can also cause abnormal blood clotting, leading to burst blood vessels or small clots that damage tissues and organs. These complications can lead to long-term health problems and reduce the patient’s quality of life.

Sepsis Survival Rate

Sepsis survival rates vary depending on the stage of sepsis and the time of treatment. While many people recover fully from mild sepsis, the mortality rate for severe sepsis and septic shock is much higher.

Studies show that 40% of patients with severe sepsis don’t survive, and the septic shock mortality rate can be as high as 50%. Survivors of sepsis often have ongoing health issues and are at higher risk of future infections and complications.

Sepsis in Nursing Homes

Nursing home residents are more prone to sepsis due to a combination of factors, including advanced age, chronic health conditions, and neglect or substandard care. According to the Advisory Board, 25,000 nursing home residents die each year after being transferred to a hospital with sepsis.

Many times, sepsis in nursing homes is due to preventable infections such as bedsores or UTIs that are not appropriately treated. Nursing homes are legally obligated to protect their residents from harm and provide proper medical care. When they fail to do so, the consequences are dire.

Legal Remedies for Nursing Home Negligence

If a loved one develops sepsis while in a nursing home, and you believe it was due to negligence, you may have a legal case. Nursing homes can be held liable for the following:

• Inadequate staffing, which leads to neglect of residents’ needs
• Failure to follow infection control protocols resulting in preventable infections
• Neglect of medical care, such as not treating bedsores or other conditions that can lead to sepsis deaths

Families may be entitled to recover economic and non-economic damages, including medical expenses, pain and suffering, and loss of companionship. In cases where sepsis results in death, a wrongful death claim may be filed. Nursing homes must be held responsible for their residents. Contact us if you think a nursing home’s negligence caused sepsis.