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Demystifying Sepsis and Its Stages with Tableau: Spotting Sepsis Symptom



What is Sepsis?

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency.

In other words, Sepsis is a serious condition that happens when the body’s immune system has an extreme response to an infection. The body’s reaction causes damage to its own tissues and organs.


How does a person get sepsis?

Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract.


Is sepsis contagious?

You can’t spread sepsis to other people. However, an infection can led to sepsis, and you can spread some infections to other people.


Who is at risk?

Any Infection can put you and your loved one at risk for sepsis. When germs get into a person’s body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Anyone affected by an infection, severe injury, or serious non-communicable disease can progress to sepsis, but vulnerable populations are at higher risk including:

• Older persons,

• Children younger than one,

• Pregnant or recently pregnant women,

• People who survived sepsis

• Hospitalized patients,

• Patients in intensive care units,

• People with weakened immune systems (e.g., HIV, cancer)

• People with chronic medical conditions (e.g., kidney disease).


What are the symptoms of Sepsis?


Fever or hypothermia: Sepsis can cause a high fever with temperatures above 101°F (38.3°C) or abnormally low body temperature, known as hypothermia.

Rapid heart rate: The heart may beat faster than usual, with a pulse rate exceeding 90 beats per minute (bpm) in adults.

Rapid breathing: Breathing may become rapid, with a respiratory rate of more than 20 breaths per minute in adults.

Confusion or altered mental status: Sepsis can affect the brain, leading to confusion, disorientation, and difficulty focusing.

Low blood pressure: Sepsis can cause a drop in blood pressure, leading to dizziness, lightheartedness or fainting.

Severe fatigue: Sepsis can cause extreme tiredness, weakness, shivering or feeling very cold.

Decreased urine output: Sepsis may result in reduced urine production or dark-colored urine.

Skin changes: The skin may appear mottled, with a bluish or purplish discoloration.

Difficulty breathing: In severe cases, sepsis can lead to respiratory distress and difficulty breathing.


Exploratory Analysis


In the dataset, patients are categorized into three groups: those with sepsis, defined as sepsis label=1; non-sepsis patients, defined as sepsis label=0; and onset patients, who did not have sepsis when they were admitted to the hospital but developed it later during their stay. The following chart illustrates the distribution of patients based on their sepsis label.




In Dataset MICU stands for Medical Intensive Care Unit and SICU stands for Surgical Intensive Care Unit.The following chart illustrates the comparison of MICU and SICU patients.


Demographic Analysis


Here for demographic analysis we consider age and gender. In dataset, percentage of male patients is 55.95 and percentage of female patients is 44.05.

  • Age: Analyzing the age distribution of sepsis patients can help identify whether certain age groups are more susceptible to sepsis or if age influences the severity of the condition.

  • Gender: Examining the gender distribution can provide insights into potential differences in sepsis prevalence or outcomes between males and females.


Based on the above analysis, it is evident that individuals between the ages of 60-80 are at a higher risk. Furthermore, the given dataset indicates that males are more prone to sepsis compared to females.


Stages of Sepsis

Stage one: Systemic Inflammatory Response Syndrome (SIRS)

Systemic inflammatory response syndrome may be caused by an infection, trauma, surgery, ischemia (lack of blood supply to a part of the body), or certain conditions, such as an autoimmune disorder or pancreatitis.

Inflammatory Response Syndrome (SIRS), which only becomes sepsis when an infection is present.

Identifying SIRS in a patient includes the following criteria:

1. Temperature >38.5ºC or <35ºC (body temperature alterations which are known as hyperthermia or hypothermia)

2. Heart rate >90 beats/min (Tachycardia)

3. Respiratory rate >20 breaths/min or PaCO2 <32 mmHg (Tachypnoea)

4. WBC >11,000 cells/mm3 or < 4000 cells/mm3, or >10 percent immature (band) forms (leukocytosis or leukopenia)

The presence of at least two or more of these criteria indicates the presence of Systemic Inflammatory Response Syndrome (SIRS). SIRS is commonly used because sepsis is considered a subcategory of SIRS. For a diagnosis of sepsis, two of the mentioned SIRS signs, along with an infection, must be present.

According to our database, the total distinct count of patients is 40,336, and the count of total SIRS patients is 24,271.

We have created a table containing vital details of patients. In this table, the 'Hour' column refers to the time (in hours) a patient spent in the ICU. 'Trigger Hour' indicates the hour at which two or more vitals of a patient reached abnormal ranges. 'Transition Hour' refers to the hour before the 'Trigger Hour.'

When a patient's condition meets the 'Trigger Hour' criteria, an email alert is sent to the doctor with the patient's details. The color in each column shows the abnormal ranges of the particular vital at the 'Trigger Hour.' Clicking on the email alert will automatically send an email to the doctor.



Stage two: Severe Sepsis

Severe sepsis occurs when one or more of your body’s organs is damaged from this inflammatory response. The second stage, called severe sepsis, is diagnosed when acute organ dysfunction begins. Any organ can be affected, your heart, brain, kidneys, lungs, and/or liver. The symptoms you can experience are based on which organ or organs that are affected. For example, if your lungs are damaged, your breathing is affected, if your kidneys are damaged, your ability to urinate is affected, and so on. People with severe sepsis can also develop a condition called acute respiratory distress syndrome (ARDS).

Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition. It develops rapidly and drastically reduces the amount of oxygen your blood gets from your lungs.

We use the formula PaO2 = 150 - (PaCO2/0.5) to extract PaO2 from PaCO2.

The P/F ratio (PaO2/FiO2 ratio) is a quick calculation that helps the medical team determine if the patient has acute respiratory distress syndrome (ARDS).

ARDS is categorized based on the following P/F ratio ranges:

  • P/F Ratio > 0 and P/F Ratio < 100 'Critical Respiratory Failure'

  • P/F Ratio > 100 and P/F Ratio < 200 'Severe Respiratory Failure'

  • P/F Ratio > 200 and P/F Ratio < 300 'Respiratory Failure'

  • P/F Ratio > 300 and P/F Ratio < 400 'Hypoxemia'

  • P/F Ratio >= 400 'Normal Range'

After analysis, we found the following distribution of patients based on their P/F ratio categories:

  • 37 patients in the Normal Range

  • 69 patients with Hypoxemia

  • 504 patients with Respiratory Failure

  • 1019 patients with Critical Respiratory Failure

  • 1389 patients with Severe Respiratory Failure



Stage Three: Septic Shock

Septic shock is the last and most severe stage of sepsis. It is characterized by extremely low blood pressure that does not respond to intravenous (IV) fluids and medical treatment. Septic shock occurs when the body's response to an infection leads to widespread inflammation, causing organ dysfunction and failure. Specifically, septic shock is defined by the presence of hypotension, which is low blood pressure induced by sepsis, even after fluid resuscitation. Additionally, perfusion abnormalities, such as elevated lactate levels, may be observed. The mortality rate for septic shock is high, with estimates ranging from 30% to 50%. This condition is a critical medical emergency that can lead to multiple organ failure and, if not promptly treated, may result in death. Immediate medical intervention is crucial to stabilize blood pressure, support organ function, and provide appropriate antibiotics to combat the underlying infection. Septic shock requires intensive care in a hospital setting, often in an intensive care unit (ICU). Treatment involves aggressive fluid resuscitation, vasopressor medications to elevate blood pressure, and targeted antibiotic therapy to control the infection. Supportive measures to maintain organ function and oxygenation are also essential. If septic shock is suspected, it is crucial to seek immediate medical attention. Early recognition and timely intervention significantly improve the chances of survival and reduce the risk of complications.


Conclusion

Sepsis is a life-threatening condition that demands our attention and understanding. By recognizing the key symptoms such as fever, rapid heart rate, and confusion, we can take early action and seek prompt medical attention. Timely intervention is critical in preventing the progression to septic shock and reducing the high mortality associated with this condition. Let us join hands in spreading sepsis awareness, educating our communities, and empowering ourselves with knowledge. Together, we can make a significant impact in the fight against sepsis and save lives.


References


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