Sepsis:
Prevent it.
Spot it.
Treat it – beat it.
World Sepsis Day Newsletter
05 /2014
World Sepsis Day: One day, year-long effort +++ Strategic Goals and what you
can do! +++ A perspective on ARISE +++ Take Position: pay-for-performance +++
Community-acquired sepsis +++ World Health Day +++ Sponsor news
page no. 1 | 8
That was World Sepsis Day, 2014 – a one day, year-long effort.
More than 220 events.
Every continent – over 40 countries.
From educational events
to quality improvement.
Interested in a printed version of our A0 size
overview poster of World Sepsis Day 2014 ?
Mail us by 11th November at office @ world-sepsis-day.org
Don’t forget to state your postal delivery address and name!
POLAND
World Sepsis Day: 13 September 2014
The Global Sepsis Alliance and its founding
members have joined forces with other healthcare
organizations to initiate the World Sepsis Day
movement. The campaign has been made
possible thanks to the expertise of our founding
organizations and the professionals behind them,
as well as the support of outstanding experts
from around the world. With our campaign we are
educating medical professionals, informing
policymakers, and creating awareness among
the general public.
Our aim is to reduce the incidence of sepsis
20% by 2020.
What you can do:
Healthcare Professionals: Only what is counted counts!
Please take care that sepsis is coded according to the
WHO Coding system.
WHO
Establish sepsis and relevant treatment within
the WHO
Sepsis Survivors or family, relatives and friends who lost
someone due to sepsis: Speak up about sepsis. It‘s crucial
– your first hand experience helps to raise awareness.
Global Burden of Disease Report
Recognizing the global burden of sepsis in the
Global Burden of Disease Report
Please become a supporter of World Sepsis Day and sign
the World Sepsis Declaration: www.world-sepsis-day.org
Countess of Chester Hospital
Pediatric sepsis IKT event
Aberdeen
NHS - Grampian
Pink Picnic
Cheltenham
NHS - Gloucestershire Hospitals Patient story video
Lecture
Display package
Chester
Countess Of Chester Hospital
Information display
Gateshead
Parker Domnick Hunter
Awareness day
Glasgow
MD Anderson
Cancer Center
Michael E. DeBakey
Sepsis Awareness
Veterans Affairs Medical Campaign
Center (MEDVAMC)
Informative events
Educational event
The Medical Center
of Lewisville
Lexington
T2 Biosystems
Pink Picnic
Midland
MidMichigan
Medical Center
Lectures and
public campaign
MidMichigan Medical Center
Jonathan R. Vasiliou Foundation
HUNGARY
Conquest Hospital
Fiona Elizabeth Agnew Trust
(FEAT) & Scottish Patient
Safety Programme
Presentations &
networking session
Kaunas
Lithuanian University
of Health Sciences
Lectures
& blood donation
Kaunas
Cwm Taf University Health Board Information display
& Dewi Sant Hospital
& medical training
Vilnius University
Lithuanian University
of Health Sciences
Students conference
Pontypridd
Vilnius
Vilnius University
Conference, lectures
& Pink Picnic
Vilnius
Vilnius University
Medical Faculty
Medical training
& discussion
Vilnius
Vilnius University
Lithuanian University
of Health Sciences
Marathon team
& blood donation
Reading
Royal Berkshire Hospital
Salford
Salford Royal NHS
Foundation Trust
Simulation training
Stornoway
NHS - Eileanan Siar
Learning session
Tonypandy
Ysbyty Cwm Rhondda Hospital
Information display
West
West Hertfordshire Hospitals
Hertfordshire
Display, quiz & video
York
Information displays
Lecture
Major conference
London
UK Sepsis Trust
Cycle for Sepsis
London
UK Sepsis Trust
Inaugural Ball
Sepsis Master Class
York Teaching Hospitals
NHS Foundation Trust
IRELAND
ITALY
Royal Glamorgan Hospital
Pontypridd
King’s College Hospital
UK Sepsis Trust Sepsis Parliament
NETHERLANDS
West Hertfordshire Hospitals
CROATIA
Symposium Lunteren
Panel discussion
Berlin
Vivantes Klinikum am Urban Lecture
Greifswald
Universitätsmedizin
Greifswald
Lecture
Heidelberg
Universitätsklinikum
Heidelberg
Symposium
Jena
Universitätsklinikum Jena
Awareness event
& Pink Picnic
Olpe
Krankenhaus Olpe
Lecture
Rüsselsheim
GPR Klinikum
Lecture & breakfast
Students conference Kaunas
Conference Vilnius
Blood donation Kaunas
Pink Picnic Vilnius
Education meeting Erzurum
Education meeting Gaziantep
Education meeting Izmir
Education meeting Malatya
Education meeting Samsun
Education meeting Van
Awareness event Ankara
Milan
Éupolis Lombardia
Conference
Lunteren
Zagreb
Our Lady of Lourdes Hospital
Modena
Nuovo Ospedale Civile
S. Agostino-Estense
Patient information
National Patient Safety
Program The Netherlands
Somers Point
Shore Medical Center
Educational event
Tuscany
Florida Hospital
North Pinellas
Pink Picnic
Italian Society
of Intensive Care
Symposium
Tarpon Springs
Croatian Society of Nurses
in Anesthesiology,
Reanimatology, Intensive
Care and Transfusion
Rome
Gemelli Teaching Hospital
Sepsis Masterclass
Washington, D.C.
Rory Staunton Foundation
National Sepsis Forum
Washington, D.C.
BD Diagnostics
Global Sepsis Alliance
Lecture
Helios Kliniken
Symposium Heidelberg
Medical training Vilnius
Istanbul
Education meeting Edirne
Drogheda
Zombie gauntlet
Universitätsklinikum Jena
TURKEY
Lectures Zagreb
Sepsis Heroes event
Panel discussion Berlin
Marathon Vilnius
Education meeting Bursa
Sepsis Alliance
Symposium
Symposium
Sepsis-Stiftung
and others
Education meeting Adana
Johnathan R.
Vasiliou Foundation
Master classes, video,
presentations, displays
Information display
& quiz for staff
Helios Kliniken
Berlin
Education meeting Ankara
New York
Our Lady of Lourdes Hospital
Universitätsklinikum
RWTH Aachen
Bad Berleburg
Launch of national program Istanbul
New York
Shore Medical Center
LITHUANIA
Sepsis Parliament
Information display
Royal Glamorgan Hospital
Royal Berkshire Hospital Reading
Conference
Information display
& quality management
Sepsis Week &
information display
King’s College Hospital
UK Sepsis Trust Cycle for Sepsis
Becton Dickinson
UK Sepsis Trust
Conquest Hospital
Llantrisant
York Teaching Hospitals
Conference
Minehead Community Hospital
Hull and East Yorkshire
Hospitals Trust
London
Ysbyty Cwm Rhondda Hospital
SepsEast &
University of Szeged
London
Hastings
UNITED STATES OF AMERICA
Houston
UK Sepsis Trust Inaugural Ball
Minehead
Hull
McMaster University
Houston
Parker Domnick Hunter
Pink Picnic
Lectures
Aachen
Gy r
Presentations Glasgow
McMaster University
McMaster University
&Hamilton Health
Sciences
Summerside Prince County Hospital
Salford Royal
Polish Housewife
Polish Sepsis Group
GERMANY
SepsEast Conference
Budapest
UNITED KINGDOM
Hamilton
Hamilton
Lewisville
A truly global effort to fight sepsis.
On every continent. In over 40 countries.
United Nations: General Assembly
Recognition of World Sepsis Day as World Day
World Sepsis Day operates at a truly global
level. Different countries and regions act
according to their local healthcare systems and
economic means. We are proud to look back at
such a successful World Sepsis Day 2014.
CANADA
Outlook: World Sepsis Day strategic targets
The recognition of sepsis by global health
authorities is one key in reducing sepsis incidence
20% by 2020.
Pink Picnic Poznan
Poznan
Wisla
Aberdeen
1st stage of national
education meetings
on awareness
Kayseri
Kayseri Erciyes University Symposium
Ankara
Turkish Medical and
Surgical Intensive Care
Society
Lectures
Stornoway
Launch of national
program for sepsis
education
Turkish Society of
Intensive Care &
Ministry of Health
Ankara, Istanbul
Turkish Society of
Adana, Bursa,
Intensive Care &
Edirne, Erzurum,
Ministry of Health
Gaziantep, Izmir (2),
Kayseri, Konya,
Malatya, Samsun,
Van
Awareness event
Glasgow
Patient information Modena
Éupolis Lombardia
Drogheda
Salford
Chester
Pontypridd & Tonypandy
Cheltenham
Llantrisant
London
Minehead
Hastings
Florida Hospital North Pinellas
Kaunas
Gateshead
York
Cottingham
Vilnius
Olpe
Aachen
Munich
Gyor
Education meeting Kayseri
Education meeting Konya
Kruševac
Greifswald
Lunteren
Poznan
Berlin
Bad Berleburg
Jena
Wisła
Rüsselsheim
Heidelberg
Augsburg
Paris
Summerside, PEI
SERBIA
General Hospital Kruševac
Lectures
Budapest
Szeged
Midland, MI
Hamilton, ON
Lexington, MA
Zagreb
Milano
Modena
Italian Society of Intensive Care
Gemelli Teaching Hospital
KOREA
Kruševac
Tuscany
Barcelona
New York, NY
T2 Biosystems
MD Anderson Cancer Center
Ankara
Palma
Korean Society of Critical
Care Medicine
Erzurum
Kayseri
Izmir
Elche
Malatya
Konya
Symposium Seoul
Seoul
Istanbul
Bursa
València
Washington, D.C.
MEDVAMC Awareness Campaign
Samsun
Edirne
Rome
Somers Point, NJ
The Medical Center of Lewisville
Van
Symposium
Seoul
Tokyo
Yokohama
Gaziantep
Adana
Nagoya
Lewisville, TX
Houston, TX
FRANCE
Institut Pasteur
PEMEX Conference
Hospital Juárez de México
Symposium
Mexican Group for the
Study of Intensive Care
Medicine (GMEMI)
Academic event
and Pink Picnic
Mexico City
Hospital "Dr. Manuel
Gea González"
Symposium
Mexico City
Hospital Central Sur de
Alta Especialidad PEMEX
Symposium, conference
and public event
Symposium
Mexico City
Round table discussion Elche
Barcelona
Paris
Tarpon Springs, FL
MEXICO
Mexico City
Mexico City
SPAIN
Sociedad Catalana
de Pediatría
Presentation &
discussions
Barcelona
Vall d' Hebron
University Hospital
Quality Management
Initiatives
Elche
Hospital General
Universitario de Elche
Round table discussion
Palma
de Mallorca
Hospital Son Llàtzer
Patient information
València
Hospital de Sagunto
Presentations &
open forum discussion
Institut Pasteur
San Juan
Belize City
Hospital Son Llàtzer
Kathmandu
JAPAN
Sepsis Rally Kathmandu
Kathmandu
Lucknow
Jaipur
Nepal Critical Care
Development Foundation
Karachi
Doha
Sepsis Rally
Rajkot
Aurangabad
WSD Thailand 2014
Bangkok
GMEMI academic event
Hospital “Dr. Manuel Gea González”
GMEMI Pink Picnic
Cali
NIGERIA
QATAR
PAKISTAN
INDIA
San Juan
Kano
Doha
Karachi
Aurangabad
ISCCM Maharashtra
Hospital Pediátrico
Universitario Dr. Antonio Ortíz
Kano State WSD
Celebration Chapter
Hamad General Hospital
Pakistan Society of Critical
Care Medicine
Advance Sepsis
Management Course
Symposium
Bhavnagar
The Criticare
Symposium
Symposium
Gurgaon
Max Super Speciality Hospital
Sepsis Week San Juan
Cali
Sincelejo
VENEZUELA
Clinica Universitaria Rafael Uribe
Uribe Universidad Libre - Universidad
del Valle UCIPED Corporacion.
III Simposio
Nacional de
Sepsis
Belize City
Colombian Association Infectology
Caribbean Region
Symposium
Belize City
Belize Medical and Dental
Association and Belize
Society of Critical Care Medicine
Symposium
Karl Heusner Memorial Hospital
Awareness day
Symposium & Pink Picnic
Pink Picnic Kano
Hamad General Hospital
Symposium Karachi
Palmas
Barcelona
Workshop
Jaipur
Fortis Hospital
Education
Lucknow
ISCCM Lucknow
Education
& Conference
New Delhi
Action Balaji Hospital
Education
New Delhi
Society of Critical Care
Medicine Delhi NCR
Symposium
Rajkot
Bharat Serums
Discussion
Salvador
College of physicians of
Anzoátegui State
Brasília
Conference & discussion
Discussion Rajkot
Society of Critical Care Medicine
Conference Barcelona
Karl Heusner Memorial Hospital
CBC Radio campaign
& Sepsis Forum
Public awareness events Yokohama
Sepsis Easy
Sepsis Easy
Round table discussion
& public campaign
Jakarta
INDONESIA
PHILIPPINES
Jakarta
Manila
Philippines Department
of Health
Surprise Pink Picnic
Indonesian Society of
Intensive Care Medicine
Manila
Section of Pediatric Critical
Care Medicine of the
University of Sto. Tomas
Hospital
Video presentation
Socializing Sepsis Campaign
Vitória
Symposium Belize City
Public awareness events
Department of Emergency
& Critical Care Medicine,
Nagoya University Graduate
School of Medicine
Bangkok
Belo Horizonte
Symposium Cali
Seminar & discussion
Japanese Society of Intensive
Care Medicine and Japanese
Association for Acute Medicine
Nagoya
Radio Campaign Nagoya
THAILAND
PUERTO RICO
Sepsis Week & Pink Picnic
Quito
BELIZE
COLOMBIA
Japanese Society of Intensive
Care Medicine and Japanese
Association for Acute Medicine
Yokohama
Manila
Barcelona
Hospital Juárez de México
Tokyo
Bhavnagar
Kano
Sincelejo
NEPAL
New Delhi
Gurgaon
Socializing Sepsis Campaign
Symposium Sincelejo
Rio de Janeiro
Pink Picnic Manila
Hospital Unimed Vitória
São Paulo
LAMIB
Wauchope
Porto Alegre
The Criticare
ISCCM Lucknow
Newcastle
Pelotas
Sydney
Buenos Aires
CHILE
ECUADOR
Temuco
Quito
Federación Panamericana
e Ibérica de Sociedades
de Medicina Crítica y
Terapia Intensiva
Pediatric Intensive Care Unit
at Hospital de los Valles
Symposium
Congress
Symposium Quito
Congress Temuco
BRAZIL
Brasília
Belo
Horizonte
Niterói
Hospital Santa Luzia
Lectures
Hospital Madre Teresa
Lectures
Complexo Hospitalar de Niterói
Lectures
Palmas
Hospital Geral de Palmas
Lectures
Pelotas
Hospital Escola da Ufpel
Sepsis Week
Pelotas
Hospital São Francisco de Paula
Actions & lectures
Porto Alegre Hospital São Lucas da PUC
Actions
Rio de
Janeiro
Hospital Clínicas de Padre Miguel
Lectures
Rio de
Janeiro
Hospital Municipal Souza Aguiar
Sepsis Week
Rio de
Janeiro
Hospital Universitário Pedro Ernesto Sepsis Week
Salvador
São Paulo
Liga Acadêmica de Medicina
Intensiva da Bahia
Hospital AC Camargo
Hospital Clínicas de Padre Miguel
Hospital Universitário Pedro Ernesto
Hospital Municipal Souza Aguiar
Hobart
ISCCM Maharashtra
Hospital Santa Luzia
Hospital Escola da Ufpel
Hospital São Francisco de Paula
Hospital AC
Camargo
Clínicas
de Padre
Instituto Americano de Sepse
AUSTRALIA
Irmandade Santa Casa
Sepsis Forum
Hospital Mboi Mirim
Hospital Santa Marcelina Itaquera
Actions & lectures
São Paulo
Hospital São Paulo
Actions
Sanatorio Anchorena and
Fundación Favaloro
São Paulo
Instituto Americano de Sepse
Sepsis Forum
Symposium
São Paulo
Irmandade Santa Casa de São Paulo Actions & lectures
Vitória
Hospital Meridional
Lectures
Vitória
Hospital Unimed Vitória
Lectures
Symposium Buenos Aires
Complexo Hospitalar de Niterói
Lectures
São Paulo
São Paulo
Buenos Aires
ARGENTINA
Melbourne
Temuco
Lectures
Hospital Madre Teresa
Hospital Geral de Palmas
Hospital São Lucas da PUC
Hospital
Hospital São
Clínicas
Paulode Padre
Hospital Mboi Mirim
Hospital Santa Marcelina Itaquera
THANK YOU TO OUR SPONSORS
Hobart
Royal Hobart Hospital
Melbourne
Royal North Shore Hospital
Wauchope District Memorial
The Northern Hospital
Calvary Mater Newcastle
Sepsis education
The Northern Hospital
Sepsis education
Newcastle
Calvary Mater Newcastle
Road Show & quiz
St Leonards
Royal North Shore Hospital
Lecture
Victoria
ARISE
Wauchope
Wauchope District
Memorial Hospital
Education board, quiz
& sepsis education
Erin Kay Flatley Memorial Foundation | Roche | Adrenomed | Pfizer Pharma GmbH
Copyright: World Sepsis Day 2014 | Powered by Lindgruen-Gmbh
next page ▾
World Sepsis Day
Newsletter
05 /2014
page no. 2 | 8
World Sepsis Day 2014 – a short overview:
After 2012 and 2013, which focused on establishing the movement, 2014 centred on
realizing the goals as they are laid out in the World Sepsis Declaration.
Achieved milestones World Sepsis Day 2014:
The WHO began by promoting World Sepsis Day with the
following actions:
_ Sending a note of support for WSD to their mailing list
of over 20 000 contacts
_ Sending a note of support for WSD to over 17 000
healthcare facilities that are part of the WHO‘s global
campaign on hand hygiene
_ Posting information on the Patient Safety home page
with the link to the WSD website (http://www.who.int/
patientsafety/en/)
They have furthermore informed us that they look forward
to further collaboration with GSA. This is especially timely
because of its relevance to Ebola.
United Nations General Assembly:
_ First contacts have been established
Communication:
_ Spanish Website
_ Newsletter enhanced professionally to three languages
_ Fundraising event & donation online international
_ SoMe outreach
_ Network/supporter activities
_ World Sepsis Day Movie, in 6 languages
(Japanese is nearly complete)
_ Network communication and activation through mailings
(e.g., posters, press releases and more)
Collaboration:
_ Evidence4action / MamaYe
_ WAAAR (World Alliance Against Antibiotic Resistance)
_ Life after Sepsis Survey
_ Australian Sepsis Network
New Ambassadors:
_ Dr. Tom Frieden, Director CDC, USA
_ Prof. Johanna Wanka, Federal Minister of Education
and Research, Germany
_ Prof. Dorel Sandesc, Vice Federal Minister of Health,
Romania
We would like to welcome:
_ Prof. Jean Carlet, FR (Steering Committee & Expert)
_ Prof. Jean-Marc Cavaillon, FR (Expert)
_ Prof. Jean-Francois Dhainaut, FR (Expert)
_ Dr. Janet Diaz, USA (Steering Committee & Expert)
_ Prof. Simon Finfer, AU (Steering Committee)
_ Prof. Majid Mokhtari, IR (Steering Committee & Expert)
_ Prof. Zsolt Molnár, HU (Steering Committee)
_ Prof. Necmettin Ünal, TR (Expert)
We would like to thank Michael O‘Leary for his great work in
2012 and 2013. Michael O‘Leary was a highly valued member
not only in the World Sepsis Day Steering Committee but also
in ANZICS. Both engagements are now taken on by Simon
Finfer. The input of all Steering Committee Members is highly
valued – their regional and national engagement helped to
establish World Sepsis Day.
Supporters of World Sepsis Declaration
The goal in 2014 was to establish sustainable strategic collaborations. In 2013 the goal has been to increase the supporter
base, especially in the cluster of hospitals.
Dec.
2012
Sep.
2013
Sep.
2014
Hospitals & Healthcare
Services:
1,237
2,600
3,053
Non-Profit
Organizations:
143
220
295
Total Non-Profit &
Hospitals:
1,380
2,820
3,348
Healthcare
Professionals
1,529
1,478
2,071
Private Individuals
<50
537
929
Total
2,959
4,835
6,348
Events
Over 148 Events reported to World Sepsis Day Headquarters
in over 30 countries by 30th September. These are significantly
more events actively reported than in 2013! There were
approximately as many as 50% unreported events in 2012
and 2013, with information gathered informally at talks and in
conference settings by personal contacts. Given this, the full
event outreach could be, in a conservative estimate, around
220-300 events.
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World Sepsis Day
Newsletter
05 /2014
page no. 3 | 8
Outreach
1-30th September 2014
Frankfurter Allgemeine Zeitung / Deutschland: http://
www.faz.net/aktuell/wissen/seuchen-und-systemeebola-dengue-sepsis-13180968.html
Media Reach:
• Reports indicate approximatley 250 newspapers (not PR
portals) and 22 500 news items published online and/or
print features around the world in English, Spanish,
Mandarin Chinese, Arabic, German, French, Portuguese,
and other major languages of Europe, Asia and Africa.
•Reports indicate up to 3000 radio features
•Reports indicate up to 150 TV features
Deutsche Welle / Online (Ger & Eng): http://www.dw.de/
sepsis-unerkannt-oft-lebensgefährlich/a-17917596
International Press Releases:
Headline Search Online: Grand Total: 51,109
Top Release Watch Links: 63,304,200 (Reach: top online
sites that have posted your news release, as measured by
the number of visitors that frequent that site per day.)
Some Highlighted Features:
Times of India / India: http://timesofindia.indiatimes.com/
city/aurangabad/Lack-of-awareness-giving-rise-tosepsis-deaths-Experts/articleshow/42853618.cms
NY Times / USA: http://www.nytimes.com/2014/09/19/
nyregion/an-effort-to-raise-awareness-of-sepsis-led-byfamilies-touched-by-it.html
CBS News / USA: http://www.cbsnews.com/news/sepsisdeath-of-rory-staunton-prompts-his-parents-to-raiseawareness/
Telegraph / UK: http://www.telegraph.co.uk/health/1104
7019/Sepsis-is-on-the-rise-warns-medical-expert.html
Press features have appeared in nearly all countries
with events.
Social Media Outreach
1-16th September 2014
Facebook: 2,619,940 Page Impressions // Likes: 3,819
Twitter: 138,300 Page Impressions // Followers: 1,976 //
Are you interested in the full report?
Click here to see more event images, examples of press
features and social media activities.
WSD14_Summary
The recognition of sepsis by the WHO is
key in reducing sepsis incidence 20% by
2020. To achieve this, we will concentrate
our activities toward recognition of sepsis
as a global burden and to get World
Sepsis Day mandated as World Day by
the United Nations.
What you can do to support this:
HÜRRIYET BURSA / Turkey
Hirado / Hungary: http://www.hirado.hu/videok/
?video=240076
Le parisienne / France: http://www.leparisien.fr/
informations/une-journee-contre-les-infections13-09-2014-4130747.php
Brazil: around 1,600 insertions
Serbia: TV Features
Die Welt / Deutschland: http://www.welt.de/gesundheit/
article132218866/Die-gefaehrliche-Blutvergiftung-kannjeden-treffen.html
Healthcare Professionals: Only what is counted counts!
Please take care that sepsis is coded according to the WHO
ICD coding system.
Sepsis survivors or family, relatives and friends who lost
someone due to sepsis: Speak up about sepsis. It's crucial
– your first-hand experience helps to raise awareness.
Please inform your contacts to become supporters of
World Sepsis Day and sign the World Sepsis Declaration:
www.world-sepsis-day.org
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World Sepsis Day
Newsletter
05 /2014
page no. 4 | 8
Perspective: Sepsis Mandates: Improving Inpatient Care While Advancing
Quality Improvement
Cooke CR, Iwashyna TJ. Sepsis Mandates: Improving Inpatient Care While Advancing Quality Improvement.
JAMA 2014; 313(14): 1397-8
In this viewpoint article, Colin Cooke and Jack Iwashyna discuss potential for
large-scale change within a healthcare system with regard to its management of
patients with sepsis through the use of financial performance incentives.
Using the U.S example of the Centers for Medicare and
Medicaid Services (CMS), they argue that considered, phased
implementation of pay-per-performance initiatives for sepsis
might ‘advance the science and practice of quality improvement to face the common reality of diagnostic ambiguity
or inadequacy.’
Once coding and data capture are addressed, a starting
point for any pay-per-performance initiative must surely be
to improve the proportion of eligible patients (for example,
those triggering an Early Warning Score) who are screened
for sepsis. In systems where clinical measurement is not
heavily resourced, it may be necessary that, rather than
assessing whole-bundle compliance, surrogates such as
time to antibiotics or to review by Sepsis Team be used. NHS
England will shortly be issuing national commissioning
levers for sepsis along these lines.
The challenge for any healthcare organization aiming to
incentivize better performance in sepsis care is to ensure
that measures reflect the need for graded implementation,
and that potential for unintended harm, including through
the over-zealous use of antimicrobials in cases of diagnostic
Well-designed, national performance incentives for sepsis
uncertainty, be addressed. The
are likely to save lives and improve
However, this cannot be a ‘one size fits
authors recognize that metrics should
quality of life for survivors by reducing
all’ approach: the complexity of the
focus not only on outcome measures,
time to delivery of the basics of care.
metrics used will be governed by
but on counselling efforts to address
They could also be used to build national
resources available for measurement
poor recognition, staging successful
registries for sepsis in order that we
and systems available to capture data.
implementation, ensuring mandates
might better understand the human
are responsive to new evidence, and targeting learning
and fiscal burden of disease, and in order that resources
rather than judging.
may be appropriated. The recommendations within this
article are key to better care.
We would agree that ‘National programs for sepsis are
needed’, and welcome the concept that financial incentives
Ron Daniels
to performance improvement would be helpful. However,
CEO Global Sepsis Alliance
this cannot be a ‘one size fits all’ approach: the complexity
of the metrics used will be governed by resources available
for measurement and systems available to capture data.
The under-recognition of sepsis is a global issue which
must be addressed. Under ICD-10 coding rules, the causative
infection must be coded as primary diagnosis with severe
sepsis secondary. Any national programme must begin with
a willingness to capture both primary and secondary codes
to identify sepsis incidence, a strategy already adopted by the
CDC. Within the UK, the Health and Social Care Information
Centre is considering this same approach, and the Global
Sepsis Alliance is lobbying the WHO to support such change.
next page ▾
World Sepsis Day
Newsletter
05 /2014
page no. 5 | 8
Perspective: The Australasian Resuscitation in Sepsis Evaluation:
The ARISE study The impetus for the ARISE study, began in 2006 following discussion
between researchers in Australia, The United States and the United Kingdom. Early
Goal-Directed Therapy for patients with severe sepsis was being recommended as
the only approach to the early resuscitation of patients with severe sepsis and septic
shock, in spite of the evidence supporting this therapy coming largely from a relatively
small trial conducted in only one centre.
While there was consensus that identifying patients with
sepsis as early as possible and commencing their specific
therapy (with antibiotics and source control) in an expedient
fashion was clearly important, there was considerable
controversy regarding the utility of some of the components
of Early Goal-Directed Therapy (for example, the potential for
giving excessive fluids, the side effects of blood transfusion
and dobutamine). There was also considerable doubt
regarding the external validity, that is, whether the results
of the trial could be replicated outside of the unique centre
where the original research was conducted.
care, in any of the trial outcomes. What do these results
mean for clinicians, both in the developed world, with
well-resourced healthcare systems and for those working
in resource-poor settings? The trial results confirm that
clinicians caring for patients with severe sepsis can focus
on providing early antibiotics, early source control, judicious
fluids titrated according to the clinical judgement of the
treating clinicians and good supportive care for their
individual patient, without requiring them to follow the
specifics of the Early Goal-Directed Therapy protocol for
all patients.
Out of these discussions the ARISE study was conceived to
test whether patients with early septic shock would have a
lower mortality rate at 90 days receiving Early Goal-Directed
Therapy compared to usual care in a variety of healthcare
settings, across a variety of countries. The study was
conducted in 51 centres, largely across Australia and New
Zealand, but also Hong Kong, Finland and the Republic of
Ireland. Not only were large academic hospitals included,
but metropolitan and rural centres were also included to
ensure that the results of the study would apply in a wide
variety of healthcare settings.
The ARISE study has been a remarkable success on a number
of levels. There has been a tremendous level of co-operation
between Emergency Departments and Intensive Care units
involved in the study to enable the development and
implementation of the study protocol and to successfully
complete the study. There has also been an unprecedented
level of international collaboration between the three teams
running parallel trials in Australasia (The ARISE study), the
United Kingdom (the ProMISe study), and the United States
(The ProCESS) study. This close collaboration means that
the results of all three trials can be combined in a database
to allow more research to be done in the process of finding
new ways to reduce the mortality of severe sepsis.
After commencing recruitment in October of 2008, the
final trial participant was recruited in April of 2014, and the
results of the trial have recently been released at the
European Society of Intensive Care Scientific Meeting in
Barcelona and via the New England Journal of Medicine.
The primary result of the trial showed no difference in
mortality between the trial participants randomised to
receive Early Goal-Directed Therapy and those who were
randomised to receive usual care. There was no difference
found in the time the trial participants in each group spent
in the ICU or in hospital. In fact, there were no major
differences between the patients who received Early GoalDirected Therapy and those who received just good usual
One of the other successes of the trial has been the
increased interaction with stakeholders via social media.
The ARISE study has a Facebook page and a Twitter account
(@TheARISEstudy). These new modes of communication
were designed to facilitate dialogue with study sites and
local investigators during the recruitment period of the trial,
allowing local sites easy access to the study investigators
to answers questions regarding the study protocol or local
implementation strategies. More recently these media have
facilitated an ongoing engagement between the research
team and clinicians and those interested in discussing the
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World Sepsis Day
Newsletter
05 /2014
page no. 6 | 8
results of the study on blogs and via podcasts, …click here
to join. By reaching out via social media networks, the
research team is attempting to hasten the translation of
this valuable evidence into clinical practice so that the care
of patients with severe sepsis can continue to improve.
After all, this is really the point of performing studies,
such as the ARISE study, to improve the care of patients
with sepsis.
Prof. Sandra Peake
Anthony Delaney
Patient arrives in the
emergency department
Time to randomization from
arrival in the emergency
department in minutes
Early Goal-Directed Therapy (EGDT): Placement of a central
venous catheter to monitor pressure and ScvO2 and to
administer intravenous fluids, vasopressors, dobutamine,
or packed red-cell transfusions. Team approach with a set
of 6-hour resuscitation instructions.
Protocol-based standard therapy (ST): Adequate peripheral
venous access and administration of fluids and vasoactive
agents to reach goals for systolic blood pressure and shock
index and to addres fluid status and hypoperfusion.
Usual care (UC): Decisions about the location of care
delivery, investigations, monitoring, and all treatments
were made by the treating clinical team.
Duration of stay in ICU
and hospital in days
Deaths by
90 days
ProCESS study (31 centers in the US)1
,k
ED
5,1
197
n=439
EGDT
n=446
ST
185
n=456
UC
181
5,1
4,7
31,9%
11,1
30,8%
12,3
33,7%
11,3
ARISE study (51 centers, mostly in Australia or New Zealand)2
, k ED
n=796
UC
n=792
EGDT
4,7
178
4,9
186
Kumar et al. (24 centers in Canada and the US)3
Survivors
in percent
100%
80%
40%
20%
0 1 2 3 4 56
9
12
Time in hours till start of therapy
24
14,1
18,8%
18,6%
Early
recognition
and
treatment
save lives.
60%
Adult
patients with
antibiotic
therapy
15,1
36
1_ The ProCESS Investigators: A randomized Trial of
Protocol-Based Care for Early Septic Shock. N Engl J Med:
March 18, 2014 //
2_ The ARISE Investigators and the ANZICS Clinical Trials
Group: Goal-Directed Resuscitation for Patients with Early
Septic Shock. N Engl J Med: October 1, 2014. //
3_ Kumar A, Roberts D, Wood KE, et al.: Duration of hypotension
before initiation of effective antimicrobial therapy is the critical
determinant of survival in human septic shock. Crit Care Med,
34: 1589-1596, 2006.
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World Sepsis Day
Newsletter
05 /2014
7
page no. 7 | 8
Perspective: Community-acquired sepsis - an underestimated challenge
Recent studies prove that sepsis is not only an
underestimated problem in hospital settings, but also in
outpatient and emergency care. Since studies like ProCESS
and ARISE underlined the importance of early recognition
and treatment of sepsis in the Emergency Department (ED),
we know about the key role of the ED in the successful
management of sepsis. However, there is data that suggests
that Emergency Departments and other outpatient facilities
are not sufficiently trained in the early diagnosis and
management of sepsis. Older epidemiological studies found
an incidence of 140 sepsis cases in the ED setting per a
population of 100,000 (Strehlow et al. 2006) and may
underestimate the real burden of sepsis in the ED.
Recently, Henriksen et al. (Henriksen et al. 2014) found
that in a cohort of 8,358 medical ED-patients in the years
2010 and 2011 in Sweden, about 20% presented with any
form of sepsis. Based on those estimates, they concluded
an annual incidence rate of 731 sepsis patients admitted to
EDs per 100,000 inhabitants. The main focus of sepsis was
pneumonia (63%), followed by urinary tract infections (24%)
and abdominal infections (11%).
This is in accordance with another epidemiological study
from the US (Seymour et al. 2012): They found that from
2000-2009 the incidence of severe sepsis in the ED more
than doubled and in 2009 they observed an incidence of
3,3 severe sepsis cases per 100 ED patients, exceeding the
incidence of acute myocardial infarction (2,3 patients/
Changes in the rates of hospitalizations with
severe sepsis among emergency medical services*
In summary, sepsis is a major challenge for healthcare
systems all around the world – and particularly members
of the ED team hold a key position in early recognition and
therapy of sepsis. Therefore, they need to be trained in an
appropriate way to be able to provide optimal patient care.
That is why adequate teaching on early sepsis recognition
and evidence-based sepsis management has to become part
of the medical school training and professional education
for healthcare providers in both inpatient and outpatient
facilities all over the world. Until now, sepsis is not
sufficiently covered by the curricula of nurses, paramedics
and medical students compared to other conditions like
stroke, acute myocardial infarction or trauma – this needs
to change.
It is the aim of the GSA and the World Sepsis Day movement
together with the national and international supporters to
raise awareness for this hidden healthcare disaster. Given
the magnitude and the multifactorial causes of the problem,
joint actions of all stakeholders are urgently needed which
should ideally be developed and focused in national action
plans currently in demand in some countries like Germany
and the US.
Germany: Nationwide action plan to fight sepsis
USA: First national sepsis forum
For further information, visit: www.world-sepsis-day.org
Konrad Reinhart
Chairman Global Sepsis Alliance
400
Adjusted rate per 10 000 EMS
100 ED patients) and stroke (2,2/100 ED patients). This data
clearly proves that sepsis is not a problem which is limited
to the hospital setting.
Severe
Sepsis
Carolin Fleischmann, MD
300
Acute
myocardial
infarction
200
Severe
Sepsis
Literature
Henriksen DP, Laursen CB, Jensen TG, Hallas J, Pedersen C, Lassen AT. 2014.
Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical
Patients – A Population-Based Survey. Crit Care Med.
Acute
myocardial
infarction
*Seymour CW, Rea TD, Kahn JM, Walkey AJ, Yealy DM, Angus DC. 2012. Severe
sepsis in pre-hospital emergency care: analysis of incidence, care, and outcome.
Am J Respir Crit Care Med, 186 (12):1264-1271.
Stroke
Strehlow MC, Emond SD, Shapiro NI, Pelletier AJ, Camargo CA, Jr. 2006. National
study of emergency department visits for sepsis, 1992 to 2001. Ann Emerg Med, 48
(3):326-331, 331 e321-323.
Stroke
100
2001
2003
2005
2007
2009
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World Sepsis Day
Newsletter
05 /2014
page no. 8 | 8
Thanks to our sponsors & all those driving forces behind World Sepsis Day
To organize and provide website maintenance, campaign
material and this newsletter is both time- and resourceconsuming. Without the donation of our sponsors and private
philanthropic donors this would not be possible.
We rely on donations. If you like what you see and value the
work we are doing, please donate here.
We would like to thank:
Center for Sepsis Control and Care: For donating the
greatly-needed resources of a part-time assistant and
communication budget.
B | Braun: For being a one-year Bronze and currently a
three-year Silver Sponsor to 2015
ThermoFisher Scientific: For ongoing support and
Silver Sponsoring in 2014
Becton Dickinson and Company For Bronze status in 2014
and supporting World Sepsis Day with numerous events in
2014.
CSL Behring: For being a Sponsor to 2013 and especially for
Silver Sponsoring in 2014
And Adrenomed, Alere Technologies, Klinik Bavaria,
InflaRx for your valued donations.
We would like to thank especially all those private
individuals who donated such as:
• Erin Kay Flatley Memorial Foundation–
thank you Carl Flatley for your ongoing support!
• ThermoFisher Scientific: Employee Tombola
to raise funds for World Sepsis Day
and to all those great private donors. Thank you!
Important upcoming events & dates:
3-5 December 2014 International Sepsis Forum, Paris:
Sepsis 2014 Meeting
December 2014: Material for World Sepsis Day 2015
available in the World-Sepsis-Day.org toolkits
17-20 March 2015 ISICEM Brussels: GSA Joined Sepsis
Session and World Sepsis Day Supporter Meeting
1 April 2015 England: Start of government-funded national
pay-per-performance initiative for sepsis quality improvement.
9 -11 April 2015 Emirates Critical Care Conference, Dubai
Joint Session with GSA and WSD Supporter Meeting
8 - 9 May 2015 International Intensive Care Symposium,
Istanbul Joint Session with GSA and WSD Supporter Meeting
29 August - 2 September 2015 WFSICCM, Seoul:
GSA Joined Sepsis Session and World Sepsis Day
Supporter Meeting
We invite you to download the newsletter and use these key messages for your
own bulletins, website, Facebook, and/or Twitter accounts or to disseminate it to
your colleagues /other organizations or friends in your area.
Date: 5 November 2014
Responsible: Konrad Reinhart, Ron Daniels, Flavia Machado,
Niranjan Tex Kissoon, Regina Hanke
Feedback is always appreciated!
Contact: Center for Sepsis Control and Care, Erlanger Allee 101,
07747 Jena, Germany
Mail: [email protected]
Please share this newsletter and
inform us about your activities.
Stay connected
Twitter: twitter.com/WorldSepsisDay
#sepsis: information related to sepsis
#wsd15: events around World Sepsis Day 2015
#5moments: handhygiene
#pic: pink picnic
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Our sponsors
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