Understanding the Critical Role of Early Detection in Sepsis and Its Impact on Kidney Function

Sepsis:

Sepsis is a life-threatening medical condition that arises when the body's response to infection causes widespread inflammation, leading to tissue damage, organ failure, and potentially death if not treated properly. It contributes to at least 1.7 million adult hospitalizations and at least 350,000 deaths annually in the United States.

Causes of sepsis:

Sepsis is caused by the body's extreme response to infections, commonly from bacteria, but also from viruses, fungi, or parasites. Common sources include pneumonia, urinary tract infections, abdominal infections, bloodstream infections, and skin infections.

Four Stages of Sepsis:

• SIRS

• SEPSIS

• SEVERE SEPSIS

• SEPTIC SHOCK

  
  

The image below clearly illustrates the four stages of sepsis:

Primary Goal:

The primary goal of the sepsis analysis project is to achieve early detection of sepsis, which is crucial for improving patient outcomes.

Patient Categories:

• Non-Sepsis: Patients who do not develop sepsis at any point during their hospital stay.

• Sepsis: Patients who are admitted with a diagnosis of sepsis.

• Onset Sepsis: Patients who are admitted without sepsis but develop it during their hospital stay.

Early Detection of Sepsis: Why Timing Matters

Sepsis is treatable when identified early, but what constitutes early detection? For optimal outcomes, focusing on individuals who develop sepsis during their hospital stay is crucial. These patients are at a high risk of progressing to severe sepsis. Monitoring the onset of sepsis and the hour prior is essential, as every hour counts in this critical early stage. By promptly addressing these patients, healthcare providers can significantly enhance early detection and improve overall patient outcomes.

Kidney Analysis:

The kidneys serve as the body's vital filtration system, responsible for removing waste products from the bloodstream and producing urine. They are among the first organs impacted by sepsis, often resulting in acute kidney injury.

The Role of Biomarkers in Early Sepsis Detection:

Biomarkers are measurable indicators that reflect a biological condition and are instrumental in the early detection of sepsis. They help pinpoint the onset of sepsis with greater accuracy, enabling timely intervention and treatment. Key biomarkers used for detecting kidney dysfunction in sepsis patients include creatinine, blood urea nitrogen (BUN), glucose, potassium, chloride, and calcium. These indicators provide valuable insights into the patient's condition and aid in making informed clinical decisions.

Glucose:

Below chart illustrates the impact of abnormal glucose levels in onset sepsis patients concerning the time elapsed between kidney dysfunction and diagnosis. Abnormal glucose levels affect 60.33% of onset patients, making it a high-impact biomarker for kidney dysfunction. Notably, day 1 shows the highest abnormal glucose values, with 34.45% of onset patients affected, leading to kidney dysfunction. Conversely, by day 7, the incidence of abnormal glucose levels drops significantly to around 2.71%.

Acute Kidney Injury(AKI) - BUN,CREATININE & POTASSIUM:

Below chart explains the stages of acute kidney injury (AKI)—risk, injury, and severe—for onset sepsis patients with abnormal BUN (Blood Urea Nitrogen), creatinine, and potassium levels leading to kidney dysfunction or damage. Specifically, 48.92% of onset patients are in the injury stage.44.24% are in the risk stage.6.83% are in the severe kidney damage stage. Additionally, on day 1, the highest abnormal values are observed, with 35.25% of onset patients affected. Conversely, day 7 records the lowest percentage of 2.88%. This suggests that as time progresses, the incidence of AKI cases decreases significantly.

Key Biomarker Combinations for identifying Kidney Dysfunction:

Below chart highlights the top abnormal biomarker combinations that indicate kidney dysfunction in onset sepsis patients.Usually bun & creatinine play major role in kidney damage but after analyzing onset sepsis patients  we came to know that combination of glucose and calcium stands out prominently, accounting for 66.34% of onset patients leading to kidney dysfunction. In contrast, abnormal BUN (Blood Urea Nitrogen), potassium, and chloride combination is observed in only 3.60% of onset patients.

Conclusion:

To summarize, the first 24 hours are vital for monitoring and intervention to halt the progression of sepsis. It's apparent that most patients who develop sepsis show abnormal biomarker levels within this timeframe, indicating potential kidney dysfunction. This important observation allows for early identification of high-risk patients, ensuring timely treatment and improving overall outcomes.