Sepsis is a life-threatening condition that occurs when the body's response to infection goes into overdrive, damaging its own tissues and organs. It is the leading cause of death from infection worldwide, yet diagnosing and measuring its severity remains surprisingly difficult. This thesis by Carolina Hincapié Osorno examines why, and what can be done about it.
Over ten chapters, this research investigates sepsis from multiple angles. It starts by asking a fundamental question: does it matter which definition of sepsis we use? The answer is yes, dramatically so. Applying three different definitions to the same group of patients at the emergency department showed that each one identified a completely different set of patients, with almost no overlap. The definition a doctor or researcher chooses determines who gets counted as having sepsis.
The thesis also examines the scoring tools used to measure how severely ill a patient is, finding that most were designed for the intensive care unit and perform inconsistently when applied at the emergency department. It shows that where the infection is located in the body, and which bacteria is causing it, affect prognosis in ways that current tools do not capture.
Two chapters demonstrate that useful information is already being generated in routine hospital care but never used. The time it takes for bacteria to grow in a blood sample, and detailed immune cell measurements produced automatically by standard blood analysers, can both help predict which patients are most at risk, before test results are even available.
The final chapters address how sepsis research is reported and how patients are enrolled in studies, arguing that both need reform to produce evidence that is trustworthy and applicable to the patients who need it most.
Find the full thesis here: Exploring sepsis from definitions to prediction: a journey through epidemiology, clinical scores, and real-world data challenges
