September 13th is World Sepsis Day. Sepsis occurs when the body’s own defence systems can no longer contain an infection locally. The immune system ‘overshoots’ and causes a high degree of inflammation throughout the body. The body’s own defence reactions are no longer directed exclusively against the infectious agents, but against everything that gets in their way – including the body’s own tissues and organs. If left untreated, sepsis is almost always fatal due to multiple organ and circulatory failure. The earlier it is recognised, the higher the chances of survival. The Sepsis Trauma Shock Team at LBI Trauma is dedicated to the early detection of sepsis as well as a better understanding of its progression and the early recognition and treatment of its long-term consequences. Because even after surviving sepsis, for many patients nothing is as it once was.

One in five sepsis survivors are rehospitalised  within 30 days of being discharged from intensive care, and around three quarters of survivors develop a complex clinical picture known as PICS, short for Persistent Inflammation, Immunosuppression, and Catabolism Syndrome, i.e. a permanent disorder of inflammatory processes, immune defence and metabolism. As part of the international BEATsepsis project, the LBI Trauma is working on solutions to recognise the development of PICS at an early stage and, in the best case, to treat it.

According to the Federal Ministry of Social Affairs, Health, Care and Consumer Protection, around 28,000 people in Austria contract sepsis every year, and around one in four of those affected (7,500 people) die. Within Europe, around 600,000 deaths are recorded each year.

BEATsepsis: diagnostic fingerprint saves lives

BEATsepsis, a Europe-wide project with teams from eleven institutions (including university hospitals and research centres) in six countries, is dedicated to researching the long-term consequences of sepsis. The LBI Trauma is measuring inflammatory markers in the blood in order to create a kind of ‘diagnostic fingerprint’. The aim of the project is to determine correlations between disease markers and the risk of long-term consequences (PICS). With this study, BEATsepsis is making an important contribution to the distinction of the development of sepsis at an early stage and initiating appropriate (preventive) medical measures.

Myth vs. reality – for a realistic assessment of supposed sepsis symptoms

Sepsis education is also one of the declared aims of the BEATsepsis project. Even though twice as many people die from sepsis every year as from a heart attack, sepsis is often misunderstood and recognised too late – with fatal consequences. ‘We see a great need to educate people about well-known sepsis myths and the actual symptoms of sepsis,’ says Marcin Osuchowski, group leader of LBI Trauma’s Sepsis-Trauma-Shock research group. ‘World Sepsis Day is therefore a very important occasion for us to inform the entire population about actual symptoms in order to minimise the number of late-detected infections in the future.’

In order to make a trustworthy and reliable assessment of various sepsis symptoms, LBI Trauma identified some of the most well-known assumptions for the general public:

Myth 1: Sepsis can be recognised by the red line on the skin

The myth of the red line that slowly spreads and leads to death as soon as it reaches the heart is not necessarily correct. Basically, the red line itself indicates an inflammation of the underlying lymphatic system and may or may not be associated with septicaemia. Most septicaemias, however, occur without the familiar red line. Instead, septicaemia manifests itself through confusion, rapid, heavy breathing, a greatly increased pulse rate and drop in blood pressure, cold, marbled skin on the arms and legs and a severe feeling of illness.

Myth 2: Injuries are always the cause of sepsis

The term ‘septicaemia’ alone is misleading and should be avoided, according to experts. The associated myth is that you have to be injured to get septicaemia. This is false. The majority of all sepsis cases occur as a result of infections within the body, for example after lung or urinary tract infections.

Myth 3: Anyone who has survived sepsis is completely healthy again

Furthermore, there is little awareness in society of the long-term consequences that sepsis may have. Many patients often suffer from long-term symptoms such as persistent fatigue, sensory disorders, heart and kidney dysfunction or even a recurrence of sepsis. The initial relief of survival is followed by horror and a lack of understanding of the changed circumstances. Through greater awareness and an open dialogue, patients and their families can adapt better and seek targeted help.

LBG also supports national projects for the aftercare of intensive care patients

Help can be found at, for instance, Vienna General Hospital. There, a dedicated PICS study outpatient clinic is dedicated to the optimal, interdisciplinary aftercare of sepsis survivors. The Ludwig Boltzmann Gesellschaft played a key role in its establishment, in close collaboration with Prof Dr Eva Schaden, who has long been campaigning for better care for sepsis patients in Austria. The Open Innovation in Science Centre of the Ludwig Boltzmann Gesellschaft (LBG OIS) financed the co-creation workshops required to develop the project and is thus making a key contribution both nationally and internationally to improving the living conditions of patients with long-term sepsis.